What are the responsibilities and job description for the Grievance & Appeals Coordinator position at Strategic Staffing Solutions?
Job Title: Grievance &Appeals Coordinator
Location: Remote (Must be comfortable working EST)
Duration: 6 month contract with the chance of extending or converting
Engagement Description –
Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. Contact customers to gather information and communicate disposition of case. Conduct pertinent research in order to evaluate, respond to, and finalize case. Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions.
Required Skills/Experience – The rest of the required skills/experience. Include:
• Writing Letters
• Analytical thinker
• Research Skills
• Multi-tasking abilities
•Medical Insurance, Medicare/CMS Knowledge
•Customer Service
Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Grievance and Appeals experience.
• Degree in Healthcare/computer skills
• Experience in analyzing a claim
• Experience in classification between a grievance/appeal/organizational determination.
• Letter writing
• Basic computer skills. How to save a PDF, how to navigate excel, learning new systems
Education/Certifications – Include:
• Bachelor’s Degree in English, Communications or related field preferred
