HireLevel is seeking a Grievance and Appeals Coordinator in Chicago, IL.
Our client is a fortune 500 company who is a nation-wide leader in the healthcare services field and they pride themselves on their ability to provide a wide range of government sponsored healthcare programs; including a variety of insurance solutions.
Position: Customer Service Representative
Pay Rate: $20+ an hour
Shift: M-F 8am-5pm or M-F 8:30am-5pm
Similar Jobs: Claims, Healthcare, Claims Adjuster
Responsibilities of the Grievance and Appeals Coordinator:
- Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members
- Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
- Prepare response letters for member and provider complaints, grievances and appeals
- Maintain files on individual appeals and grievances
- May coordinate the Grievance and Appeals Committee
- Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
- Reach out to other departments to collect information, and keeping the systems updated and sending letters- the process is time sensitive
- Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research
- Manage large volumes of documents including copying, faxing and scanning incoming mail
Requirements of the Grievance and Appeals Coordinator:
- Associates preferred or high school diploma with years of experience
- 1 or more years of Grievance and appeals with Medicaid experience
- Excellent written communication skills
- Critical thinking
- Software- Microsoft office
Earn $25 in Referral Gift Cards!
If you refer someone to HireLevel and they are hired, work at least 30 days, and you are in good standing, we will send you a $25 gift card to say thank you! Submit your referrals at www.hirelevel.com/referral
HireLevel is an equal opportunity employer.