Appeals Coordinator Customer Experience Associate IV

Appeals Coordinator - Customer Experience Associate IV

Summary:

As an Appeals Coordinator - Customer Experienceanalyze and resolve verbal and written appeals from consumers. Respond to requests for information from Department Hearing officers.

What you will be doing:

• Research verify and evaluate case information and other factors in effort to facilitate resolution within Access Health CT procedures and federal regulations and statutes governing the program.
• Correspond with the Department of Social Services staff and hearing officers as required.
• Serve as an impartial facilitator to create and maintain good will and cooperation.
• Act as a representative at Administrative Hearings conducted via phone or in person.
• Prepare written hearing summaries detailing case circumstances and the actions taken which resulted in the eligibility determination decision.
• Perform follow-up actions as required resulting from decisions rendered subsequent to Administrative Hearings.
• Identify and report error trends discovered during the Grievance Mediation process to the Quality Assurance Supervisor.
• Effectively research interpret and explain federal state and local policies governing eligibility and participants legal rights and responsibilities.
• Work with internal business units (Payment Processing Eligibility Quality Assurance etc.) relative to error discovery reporting administrative hearings and recoupments.
• Demonstrate strong understanding of Medicaid CHIP and the Affordable Care Act
• Provide detail documentation regarding the outcome and action of the review.
• Send appropriate communication to client identifying outcome of review.
• Conduct daily monitoring and tracking of all incoming work to ensure SLAs are met.
• Consult management as needed to address questions and issues.
• All other duties as assigned.

What you get:

• Full Time Employment
• 2-3 weeks of Paid Training
• Hourly Rate $22.28
• Career Growth Opportunities
• Full Benefit Options
• Great Work Environment
• Work Schedule (Monday-Friday) 8am-5pm

People who succeed in this role have:

• The ability to convey complex information in clear and concise terms to ensure customer understanding.
• Strong work ethic.
• Effective and accurate written and verbal communication skills.
• Effective problem-solving skills.
• Can navigate multiple applications and research solutions with ease.
• Love helping people and guiding them to the best solution for their issue.
• Ability to effectively relate to a wide range of individuals from a diverse population.
• Excellent customer service skills

Requirements

• Must be at least 18 years of age or older.
• Must have a College degree (Minimum of Associates) or equivalent work experience
• 2 years of Grievance
• Must be able to successfully pass a criminal background check education/employment verification and drug test

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position actual salaries will vary and may be above or below the range based on various factors including but not limited to location experience and performance. In addition to base pay this position based on business need may be eligible for a bonus or incentive. In addition Conduent provides a variety of benefits to employees including health insurance coverage voluntary dental and vision programs life and disability insurance a retirement savings plan paid holidays and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $22.28