Grievance & Appeals Coordinator at Strategic Staffing Solutions
Job Description
Title: Grievance & Appeals Coordinator
Location: Fully Remote in EST/CST
Duration: 6+ Months with opportunity for permanent
Role Type: W2 Contract Engagement
Engagement Description
Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. Contact customers to gather information and communicate disposition of case. Conduct pertinent research in order to evaluate, respond to, and finalize case. Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions.
Top 3 Required Skills/Experience
- Experience handling a large load of work in a fast-paced environment and have computer skills!
- Insurance, Medicare/CMS knowledge
- Customer Service Experience
Required Skills/Experience
- Two (2) years customer service experience required.
- Two (2) years health insurance experience and familiarity with health insurance state and federal regulations preferred.
- Strong project management skills preferred.
- Writing Letters
- Analytical thinker
- Research Skills
- Multi-task
Preferred Skills/Experience
- Grievance and Appeals experience
- Experience in analyzing a claim
- Experience in classification between a grievance/appeal/organizational determination.
- Letter writing
- Basic computer skills. How to save a PDF, how to navigate Excel, learning new systems
Education/Certifications
- High School Diploma or GED required.
- Bachelor’s Degree in English, Communications or related field preferred.
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