Grievance Appeals Coordinator
Grievance Appeals Coordinator
Posted on :
13-10-2024
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Job Description
Overview:
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.
Title: Grievance &Appeals Coordinator
Work Location: Detroit MI 48226
Duration: 6 Months
Job Type: Contract
Work Type: Remote
Dept: MA Grievances and Appea
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 analysing interpreting data and applying contract and regulatory provisions. High School
- Diploma or GED required.
- Bachelors Degree in English Communications or related field preferred.
- 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.
Top 3 Required Skills/Experience
- Experience handling a large load of work in a fastpaced environment.
- Insurance Medicare/CMS knowledge
- Customer Service Experience
Required Skills/Experience The rest of the required skills/experience. Include:
- Writing Letters
- Analytical thinker
- Research Skills
- Multitask
Preferred Skills/Experience Optional but preferred skills/experience. Include:
- Grievance and Appeals experience.
- Degree in Healthcare
- Experience in analysing a claim
- Experience in classification between a grievance/appeal/organizational determination.
Education/Certifications Include:
- Healthcare English
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full Time
Key Skills
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