Grievance and Appeals Coordinator

Alameda, CA 94502

Employment Type: Contract Job Category: Claims Job Number: 56534 Pay Rate: 34

Job Description

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
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