Grievance and Appeals Coordinator 1

Apex Systems, Inc in Tucson, AZ

  • Industry: Information Technology - Others
  • Type: Full Time
position filled
Job Description Job : 1037596 Title : Grievance and Appeals Coordinator Pay Rate : $20/hr Hours : Mon-Fri 8-5 Job Responsibilities: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Gather, analyze and report verbal and written member and provider complaints, grievances and appeals. Prepare response letters for member and provider complaints, grievances and appeals. Maintain files on individual appeals and grievances. May coordinate the Grievance and Appeals Committee. Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information. Assist with HEDIS production functions including data entry, calls to provider's offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mail. Skills Needed: Oral, written, and problem solving skills Complaints or customer service background Microsoft Office - Word, Excel Health Plan Experience Education Requirement: High School Diploma or Equivalent required Associates or Bachelor's Degree preferred EEO Employer Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178. - provided by Dice

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