What are the responsibilities and job description for the Grievance Coordinator position at VirtualVocations?
A company is looking for a Grievance & Appeals Coordinator to manage member and provider grievances and appeals.Key ResponsibilitiesDetermine and respond to claim disputes and appeals, maintaining accurate logs and documentationEnter accepted appeals into the CRM system and maintain case files in compliance with regulationsRespond to inquiries from members and providers regarding grievances and appeals in a timely mannerRequired QualificationsHigh school diploma / GED or equivalent working knowledgeTwo years of experience in a healthcare-related field or project managementKnowledge of AHCCCS, HCG, and CMS regulationsProficiency in MS Word, Excel, and Microsoft Office SuiteFamiliarity with medical terminology and claims processing guidelines
