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Grievance and Appeals Coordinator 1
4 months ago
Job Title:Grievance and Appeals Coordinator 1
2 openings
Contract Duration: 6+ mont contract with potential to convert to full-time
Pay Rate: $20-22/hr
Location: Remote/Hybrid - must be local to Woodland Hills, CA (may need to come in for meetings)
Work Hours:M-F anywhere between 8am-6pm (staggered shifts) Must accept shift given-no flexibility in schedule.
Qualifications/Skills Needed
Must have previous Grievance and Appeals exp
Analytical and research savvy
Must have at least 1 year of recent healthcare experience and strong work history
Strong organization and able to multi-task
Attendance-must be timely and show up to work
Medical management, Utilization management, and/or running a doctor’s office
Day To Day Responsibilities Of Role
Speaking with members, documenting, researching (utilizing different material and navigating through systems, reaching out to providers & members, communicating with internal and external parties), formulating responses in writing to members (writing skills are extremely important for this role), will need to meet deadlines.
Must be ablto demonostate your ability to handle multiple tasks and balancing the case load. This position has a ton of moving parts. Time management plays a key part in this role.
Need strong candidates who have critical thinking skills and writing skills,
this is not an entry level position .
Performance Expectations
Candidate has to be available and reachable during all working hours. During the new hire training the candidates could be called in to attend an in-person training and the dates/times are not flexible. Candidate should adhere to the schedule provided and agreed upon. This department does not provide flexible schedules. Candidate should be able to meet department goals and deadlines. Candidate should be able to work in a team environment, whilst utilizing critical thinking skills. Candidates should have good writing skills.
Roles That Have Done Well
Call center experience (being able to multitask and work through various issues)
G&A experience
People who have worked in Dr’s offices (i.e. billing, talking to members, pulling records), experience dealing with members (problem solving)
Medical Management/UM
COORDINATING (coordination of care for patient or member)
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