North Carolina Grievance Coordinator
VirtualVocationsVisalia, California, United Statesjob_description.job_card.1_day_ago
serp_jobs.job_preview.job_type
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job_description.job_card.job_description
A company is looking for a Grievance & Appeals Coordinator I.
Key Responsibilities
Analyze and resolve claims and authorization appeals from providers and formal grievances from members
Prepare response letters for member and provider complaints, grievances, and appeals
Maintain files on individual appeals and grievances and support related data entry and research functions
Required Qualifications
High school diploma or equivalent; associate's degree preferred
2+ years of healthcare grievance or appeals, claims, or managed care experience
Experience in managing large volumes of documents
Ability to support pay-for-performance programs
Familiarity with HEDIS production functions is a plus
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Carolina Carolina • Visalia, California, United States
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