“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
The Appeals and Grievance (A&G) team manages all aspects of Appeals and Grievances processing including, but not limited to, intake, processing, notification, and compliance. This position, Appeal and Grievance Coordinator I, works as a member of the A&G team. Processing appeal and grievance requests in accordance with standards established for accuracy, timeliness, productivity, client performance commitments, and regulatory requirements (e.g. State Regulations, Federal Regulations, Professional Accreditations). Utilize various business applications (e.g. MedAccess, MedResponse Appeals, FileNet, RightFax, SalesForce) to perform analysis, obtain information, and enter data as required for assigned duties. Utilize reasoning skills to evaluate appeal and grievance requests for appropriateness and ensure processes are followed accordingly. Interact with internal and external customers as required. Work under general supervision, relying on work instructions, policies & procedures, and available company resources to perform the functions of the position efficiently and effectively.
Essential Functions and Responsibilities include but not limited to the following. Additional duties may be assigned.
High school diploma or general education diploma (GED); 1-2 years related experience; or equivalent combination of education and experience.
Previous health care, medical or pharmacy experience preferred. Excellent proofreading abilities and accurate data entry skills. Able to work independently, with minimal supervision and work well in groups when required.
To perform this job successfully, an individual should have knowledge of MS Office Suite. Knowledge of Microsoft Word and Microsoft Excel.
Certified Pharmacy Technician and/or state licensure as a Pharmacy Technician required. Certified Pharmacy Technician Certification preferred.
To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
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