Hiring for Grievance and appeals Coordinator

　　Tek Systems is currently hiring for Healthcare program coordinators for one of top healthcare company in Florida.

　　Description:

　　Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

　　Education/Experience: High school diploma or equivalent. Associates degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.

　　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

　　Assist with HEDIS production functions including data entry, calls to providers offices, and claims research.

　　Manage large volumes of documents including copying, faxing and scanning incoming mail.

　　Skills:

　　customer service, call center, healthcare, HIPPA, medical terminology

　　Additional Skills & Qualifications:

　　Customer Services

　　Appeals

　　Grievances

　　100% Remote, but needs to be near WH office for occasional meetings

　　Experience Level:

　　Expert Level

　　Description:

　　Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

　　Education/Experience: High school diploma or equivalent. Associates degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.

　　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

　　Assist with HEDIS production functions including data entry, calls to providers offices, and claims research.

　　Manage large volumes of documents including copying, faxing and scanning incoming mail.

　　Skills:

　　Appeals, Grievances, call center, healthcare, HIPPA, medical terminology

　　Additional Skills & Qualifications:

　　Customer Services

　　Appeals

　　Grievances

　　100% Remote, but needs to be near WH office for occasional meetings

　　Experience Level:

　　Expert Level

　　About TEKsystems:

　　We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

　　The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

　　We are an equal opportunity employers and will consider all applications without regard to race, genetic information, sex, age, color, religion, national origin, veteran status, disability or any other characteristic protected by law. To view the EEO is the law poster click here. Applicants with disabilities that require an accommodation or assistance a position, please call 888-472-3411 or email [email protected]. This is a dedicated line designed exclusively to assist job seekers whose disability prevents them from being able to apply online. Messages left for other purposes will not receive a response.