Grievance and Appeals Coordinator
4 weeks ago
We are seeking a highly organized and detail-oriented Grievance and Appeals Coordinator to join our team at A-Line Staffing Solutions.
Job Summary:The Grievance and Appeals Coordinator will be responsible for thoroughly documenting the investigation and resolution of each case, maintaining accurate and complete appeals/grievance records, and coordinating the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC appeal processes.
Key Responsibilities:- Document and track all grievances and appeals in a timely and accurate manner.
- Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, IMR, and DMHC appeal processes.
- Ensure compliance with state and federal regulations as they relate to appeal and grievance issues.
- Serve as a liaison with other departments to resolve grievance issues.
- Ensure timely communication with the Supervisor on all issues having potential risk and/or impact on operations.
- Engage in special projects as assigned/requested.
- High School Diploma or GED.
- Minimum of one to two years of experience in health services, managed care, hospital, or similar setting.
- Knowledge of managed care and medical terminology.
- Excellent verbal and written communication skills.
- Strong organizational skills.
- Proficient experience in Microsoft Word, Excel, Access, Outlook, and PowerPoint.
- Associates and/or bachelor's degree.
- Minimum of one to two years of experience in health services, managed care, hospital, or similar setting.
We offer a competitive compensation package, including a salary range of $29.10-$35 per hour based on experience, and benefits available to full-time employees after 90 days of employment.
If you are a motivated and detail-oriented individual with a passion for healthcare and dispute resolution, we encourage you to apply for this exciting opportunity.
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