Job Summary
A healthcare company is seeking a Remote Appeals and Grievance Coordinator.
Individual must be able to fulfill the following responsibilities:
- Ensure grievance and appeals cases are accurate and include the necessary elements for processing
- Identify all issues and required actions within a case, appropriately categorize cases
- Create and manage documents, correspondence and reports in a manner that meets required timeframes
Applicants must meet the following qualifications:
- Able to ensure adherence with state and federal regulatory timeframes for handling cases
- Able to develop effective and professional working relationships with internal and external stakeholders
- Able to contact members and providers to seek additional information or clarification