Job Summary
A health care provider is filling a position for a Remote Health Plan Complaints and Grievances Coordinator I in Pittsburgh.
Individual must be able to fulfill the following responsibilities:
- Organize all tasks within regulatory requirements/deadlines
- Understand and interpret medical information, recognize trends, and identify opportunities for improvement within the Health Plan
- Effectively utilize key internal and external Health Plan contacts, including: Health Plan staff, providers, and external review organizations, to help in this process
Position Requirements Include:
- Associate degree or equivalent professional work experience
- 1 year of experience in health care environment
- Demonstrated success problem solving and decision making with a solid understanding of managed care principles
- Proven excellent verbal and written presentation skills
- PC literacy with proficiency in the use of Microsoft office products
- Familiarity with ICD-10, HCPCS, and CPT4 coding and medical terminology
