Appeals and Grievances Intake Analyst

Job Description

Appeals and Grievances Intake Analyst

Associate I – BPM

Who We Are

UST HealthProof is a dynamic company with a mission to lower the cost of care and deliver the future of healthcare. Our consumer-centric approach gives our health plan customers a modern infrastructure and reduced administrative costs, helping to drive better business results for our customers — and better outcomes for our communities.

We achieve this mission together through teamwork, communication, collaboration, and focus. Our employees are our greatest assets, and we invite you to apply to be a part of our journey toward making a difference in healthcare in the United States. **

You Are**

UST HealthProof is searching for an Appeals and Grievances Intake Analyst who will support the coordination of appeals and grievances intake, requesting medical records, and member/provider requests. Promotes and supports the Appeals and Grievances team as required. **

The Opportunity**

• Provide support services to team members triaging and completing intake requests for appeals and grievances into a system.
• Requesting medical records or other documentation as needed to complete appeals and grievances.
• Maintain accurate and complete documentation of required information that meets quality standards.
• Protect the confidentiality of the member information and adhere to the company policies regarding confidentiality.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. **

What You Need**

• High school diploma or G.E.D. required.
• Associate or bachelor’s degree in a healthcare-related field is preferred.
• Current unrestricted LPN license or certified Medical Assistant designation preferred.
• Minimum of one year experience in a healthcare-related field.
• The preferred setting is a hospital, medical doctor’s office, or health insurance company.
• Appeal and grievance experience preferred.
• Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required.
• Computer literacy to include Microsoft Office products,
• Advanced technical skills in the use of hardware and software with a high degree of accuracy.
• Excellent oral and written communication skills for representation of clear and concise results.
• Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision.
• Strong time management skills.
• Must possess a high degree of accuracy, efficiency, and dependability.
• Effective written and verbal communication and feedback.
• Effective organizational skills with the ability to be flexible and prioritize tasks.
• Knowledge of educational assessments and learning strategies.
• Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling.

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by local law, UST provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York, or Washington as set forth below. **

Role Location: Remote

Compensation Range:** $28,000-$42,000

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits. **

What We Believe**

We’re proud to embrace the same values that have shaped UST HealthProof since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion, and to place people at the center of everything we do. **

Humility**

We will listen, learn, be empathetic and help selflessly in our interactions with everyone. **

Humanity**

Through business, we will better the lives of those less fortunate than ourselves. **

Integrity**

We honor our commitments and act with responsibility in all our relationships. **

Equal Employment Opportunity Statement**

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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