Appeals and Grievance Resolution Specialist

4 weeks ago

Corvallis, Oregon, United States HexaQuEST Health, Inc. Full time

Job Title: Appeals and Grievance Resolution Specialist

Job Summary:

As an Appeals and Grievance Resolution Specialist at HexaQuEST Health, Inc., you will be responsible for coordinating and resolving grievances and appeals for all members who engage with the grievance process. This role requires strong communication and problem-solving skills to ensure timely and effective resolution of complaints and inquiries from regulatory agencies, consumer rights organizations, and legislators.

Responsibilities:

  • Coordinate and resolve grievances and appeals for all members
  • Communicate with regulatory agencies, consumer rights organizations, and legislators
  • Document and monitor grievances and appeals
  • Ensure timely and effective resolution of complaints and inquiries

Requirements:

  • High school diploma or equivalent required
  • Bachelor's degree in a related field preferred
  • Three years of health plans or health insurance experience required

Working Conditions:

This role requires occasional weekend work and is a day shift position.

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