Our client, a Health Insurance organization, is looking for a Grievance & Appeals Coordinator to work remotely. Responsibilities

+ Processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies.

+ Analyze the customer’s concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.

+ Keep an accurate documentation record that details steps and action taken to resolve the customer’s 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.

Requirements:

+ Experience handling a large load of work in a fast-paced environment
...