What are the responsibilities and job description for the Grievance & Appeals Coordinator position at OpTech?
Job Title : Grievance & Appeals Coordinator
Why work at OpTech?
OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible / remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our website at www.optechus.com .
RESPONSIBILITIES :
Engagement Description :
- The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies.
- The coordinator is expected to analyze the customer's concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.
- Appeal Coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information.
- The coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer's concerns.
- The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation timeframes, accuracy and response guidelines.
- The coordinator is responsible for staying abreast of products, networks, internal policies, procedures and regulations for the accurate resolution of appeals, complaints, grievances, and inquiries.
QUALIFICATIONS :
Top 3 Required Skills / Experience :
Required Skills / Experience :
Preferred Skills / Experience :
Education / Certifications - Include :
OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws.
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