Grievance and Appeals Coordinator

Need a chance to put your skills to work, as well as find a practice that will help you learn and grow? Here is an amazing opportunity for you to work as a Grievances and Appeals Coordinator. Our client focuses on providing high quality and affordable healthcare services to low-income families.

Responsibilities and essentials:

• Verifies that all documentation is organized and complete, and that the appeal letter is logically argued.
• Ensures the documentation utilized is recorded according to internal quality standards.
• Uses the best, most compelling evidence available to support the argument presented in the appeal.
• Prepares response letter for complaints, appeals and grievances.
• Recognizes and obtains documentation to complete the appeals package.
• Identifies trends and issues and communicates the issues to supervisor
• Composes/writes appeal letters using the established insurance guidelines to resolve collection barriers.
• Responds to written and email correspondence within established timelines.

Qualifications:

• 2 + years experience in health services, managed care, hospital or similar setting
• High School Diploma
• Bachelor s or equivalent experienced preferred
• Excellent verbal and written skills
• Experience with Microsoft Word, Outlook and Powerpoint