Job Summary
A health insurance provider is in need of a Remote Appeals and Grievances Coordinator.
Individual must be able to fulfill the following responsibilities:
- Monitoring all incoming channels, including email, phone & fax for new appeals & grievances & updates to current cases
- Reviewing and screening new cases for completeness and timeliness
- Communicating with members and providers for additional information when necessary
Position Requirements Include:
- High school diploma or GED is required
- 3 years of experience in health plan operations setting, for example, Appeals & Grievances or Customer Service
- Ability to quickly learn and navigate new systems and platforms
- Thrive in fast-paced environments and have a passion for extemporary customer service and resolving conflicts
- Comfortable being on the phone with external parties including but not limited to members and providers
- Detail oriented
