Grievance Appeals Coordinator
Grievance Appeals Coordinator
Posted on :
18-01-2025
Employer Active
1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
18-01-2025
Job Description
Overview:
TekWissen is a global workforce management provider headquartered in Ann Arbor Michigan that offers strategic talent solutions to our clients worldwide. 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: 10 Months
Job Type: Contract
Work Type: Remote
Dept: Executive Services
Job Description:
- The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals grievances complaints and inquiries received from members authorized representatives and regulatory agencies.
- The coordinator is expected to analyse the customers concerns conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.
- Appeal Coordinators are expected to coordinate facilitate and conduct managerial level conferences with customers and their authorized representatives to gather and relay information.
- The coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customers concerns.
- The outcome and resolution of all appeals grievances complaints and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate regulatory and accreditation timeframes accuracy and response guidelines.
- The coordinator is responsible for staying abreast of products networks internal policies procedures and regulations for the accurate resolution of appeals complaints grievances and inquiries.
Top 3 Required Skills/Experience
- Analytical mindset having the ability to examine a matter the facts contextual information and make an informed decision or implement a reasonable rationale solution.
- Excellent written and verbal communication skills. Must be proficient in proofreading spelling grammar punctuation and math
- Ability to analyse interpret apply reason and logic conduct research structure a clear and thorough response
Required Skills/Experience The rest of the required skills/experience. Include:
- Ability to apply policies and procedures to arrive at accurate conclusions
- Ability to work in a fastpaced environment with tight deadlines and highquality standards
- Problem solving aptitude
- Accuracy and strong attention to detail
- Ability to prioritize responsibilities and effectively manage time
- Ability to work effectively with management and part of a team to meet targets
- High regard for protecting confidentiality of member employee corporate and performance information.
- Previous customer service or concierge experience (not specifically in a CSR type role)
- Strong PC application and system skills having the ability to navigate multiple computer systems and databases
Preferred Skills/Experience Optional but preferred skills/experience. Include:
- Background in writing and/or research
Education/Certifications Include:
- English/writing field of study Health Care Administration or related field history library studies Juris Doctorate etc.
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full Time
Key Skills
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