Grievances and Appeals Coordinators serve as a single point of contact to provide support and advocacy to health plan members for resolution of grievances.
Minimum of one year of recent experience as an Appeals and Grievances Coordinator.
Strong computer and telephone multitasking skills including: the ability to effectively search for and type information on the computer, navigate through multiple windows and screens quickly, and inputting information accurately while keeping pace with the call
Requires excellent verbal and written communication skills
Excellent analytical and problem-solving skills with the ability to make independent decisions.
Must have strong technical skills (Microsoft Windows, keyboarding skills, strong systems aptitude, etc.)
Ability to remain focused and productive each day though tasks may be repetitive Responsibilities:
Receives member complaints via telephone and/or written correspondence then categorizes the member complaint as a grievance, appeal, or inquiry as defined by CMS, if it is for a Medicare/Medicaid claim
Coordinate the overall grievance resolution process by evaluating and resolving oral and/or written complaints from members in compliance with federal, state, and organizational grievance procedure guidelines
Communicate decisions to members verbally or through written correspondence to close the grievance in a timely and accurate manner Preferred Qualifcations:
Previous successful work at home experience
About the Company
BroadPath provides specialized business, compliance, and technology services to healthcare payers and providers in commercial and government sectors.
We focus solely on healthcare, so our team understands our clients' issues in a way few others can. And since we work with the country's top healthcare organizations, we have unique insight into the industry's best practices and of the dynamics and regulations affecting operations and outcomes.
Employment Type: Permanent
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