Unknown Company

Grievance & Appeals Coordinator I (181964)

indiana, pa • Posted 1 weeks ago
Remote Full Time Human Resources

Job Title:

Grievance & Appeals Coordinator I

Location: Remote in Indiana (**MUST be a resident of Indiana)

Pay: $22 hourly - *weekly pay

Position Purpose:

Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

Education/Experience:

High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.

  • Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
  • Prepare response letters for member and provider complaints, grievances and appeals
  • Maintain files on individual appeals and grievances
  • May coordinate the Grievance and Appeals Committee
  • Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
  • Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
  • Manage large volumes of documents including copying, faxing and scanning incoming mail

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Grievance & Appeals Coordinator I (181964) in indiana at Unknown Company

This position is listed as full time and able to be worked remotely.

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