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Grievance and Appeals Coordinator

Chicago, IL 60604

Posted: 08/25/19 Industry: Medical Billing Job Number: 123434 Pay Rate: 23.00
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.
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