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Grievance Appeals Coordinator
A company is looking for a Grievance & Appeals Coordinator I. Key Responsibilities Analyze and resolve verbal and written claims and authorization appeals from providers Prepare response letters for member and provider complaints, grievances, and appeals Maintain files on individual appeals and grievances Required Qualifications High school diploma or equivalent; Associate's degree preferred 2+ years of experience in grievance or appeals, claims, or related managed care Experience with data entry and document management Familiarity with HEDIS production functions is a plus Knowledge of pay-for-performance programs
A company is looking for a Grievance & Appeals Coordinator I.
Key Responsibilities
Analyze and resolve verbal and written claims and authorization appeals from providers
Prepare response letters for member and provider complaints, grievances, and appeals
Maintain files on individual appeals and grievances
Required Qualifications
High school diploma or equivalent; Associate's degree preferred
2+ years of experience in grievance or appeals, claims, or related managed care
Experience with data entry and document management
Familiarity with HEDIS production functions is a plus
Knowledge of pay-for-performance programs