Grievance and Appeals Coordinator
Alameda, CA 94502 US
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