Remote - Grievance and Appeals Coordinator

Job Title: Grievance and Appeals Coordinator I

Contract Duration: 9+ months

Pay Rate: $20-22/hr

Location: Remote - Must reside in California

Work Hours: Monday- Friday anywhere between 8am-6pm (staggered shifts) Must accept shift given-no flexibility in schedule **

Qualifications/Skills Needed**

• Call center experience (being able to multitask and work through various issues)
• Grievance & Appeaks experience required
• People who have worked in Dr's offices (i.e. billing, talking to members, pulling records), experience dealing with members (problem solving)
• Medical Management/Utilization management
• 1+ year of healthcare expereince

Day To Day Responsibilities Of Role

Speaking with members, documenting, researching (utilizing different material and navigating through systems, reaching out to providers & members, communicating with internal and external parties), formulating responses in writing to members (writing skills are extremely important for this role), will need to meet deadlines. Please highlight temp worker's ability to handle multiple tasks and balancing the case load. This position has a ton of moving parts. Time management plays a key part in this role. Need strong candidates who have critical thinking skills and writing skills. **

Performance Expectations**

Candidate has to be available and reachable during all working hours. During the new hire training the candidates could be called in to attend an in-person training and the dates/times are not flexible. Candidate should adhere to the schedule provided and agreed upon. This department does not provide flexible schedules. Candidate should be able to meet department goals and deadlines. Candidate should be able to work in a team environment, whilst utilizing critical thinking skills. Candidates should have good writing skills.