Grievance &Appeals Coordinator
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Job Location:
Detroit, MI - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Overview:
TekWissen is a global workforce management provider headquartered in Ann Arbor Michigan that offers strategic talent solutions to our clients world-wide. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.
Title: Grievance &Appeals Coordinator
Work Location: Detroit MI 48226
Duration: 6 Months
Job Type: Temporary Assignment
Work Type: Remote
Dept: MA Grievances and Appeals
Engagement Description:
- Process appeals and grievances analyse research and provide comprehensive responses in accordance with established regulatory and accreditation guidelines.
- Contact customers to gather information and communicate disposition of case.
- Conduct pertinent research in order to evaluate respond to and finalize case.
- Familiar with standard concepts practices and procedures for analysing interpreting data and applying contract and regulatory provisions.
- High School Diploma or GED required.
- Bachelor s Degree in English Communications or related field preferred.
- Two (2) years customer service experience required.
- Two (2) years health insurance experience and familiarity with health insurance state and federal regulations preferred.
- Strong project management skills preferred.
Top 3 Required Skills/Experience:
- Experience handling a large load of work in a fast-paced environment and have computer skills!
- Insurance Medicare/CMS knowledge
- Customer Service Experience
Required Skills/Experience The rest of the required skills/experience. Include:
- Writing Letters
- Analytical thinker
- Research Skills
- Multi-task
Preferred Skills/Experience Optional but preferred skills/experience. Include:
- Grievance and Appeals experience.
- Degree in Healthcare/computer skills
- Experience in analyzing a claim
- Experience in classification between a grievance/appeal/organizational determination.
- Letter writing
- Basic computer skills. How to save a PDF how to navigate excel learning new systems
Education/Certifications Include:
- Healthcare English
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Key Skills
- Corporate Risk Management
- Electronics
- Infection Control
- Bakery
- ELV
- Accident Investigation
