Job Overview
We are in search of a meticulous and organized professional to join our esteemed team as a Healthcare Coordinator specializing in Appeals and Grievances. This remote role is pivotal in ensuring that appeals and grievances are processed with utmost diligence, thorough research, and compliance with regulatory standards. You will be the point of contact for customers, responsible for gathering information, updating them on their cases, and facilitating timely resolutions.
Key Responsibilities
- Assess and address appeals and grievances by conducting in-depth research and analysis to finalize each case.
- Engage with customers to obtain essential information and communicate outcomes effectively.
- Utilize your understanding of regulatory requirements, contracts, and best practices within the insurance industry to evaluate cases proficiently.
- Exhibit strong organizational skills, managing multiple cases in a dynamic environment while adhering to deadlines.
Required Skills
- Proven ability to handle a high volume of tasks while maintaining precision and attention to detail.
- Proficient computer skills with the capability to navigate various software systems.
- In-depth knowledge of insurance protocols, including Medicare and CMS regulations.
- Demonstrated experience in providing exemplary customer service in a fast-paced setting.
- Exceptional writing skills with the ability to craft clear, professional correspondence.
- Strong analytical skills complemented by excellent research abilities.
- Ability to multitask and prioritize effectively in a busy environment.
Qualifications
- A Bachelor's Degree is mandatory.
- Preferred candidates will possess experience in grievance and appeals processing.
- A background in healthcare or insurance is advantageous.
- Familiarity with claims analysis and the differentiation between grievances, appeals, and organizational determinations is beneficial.
- Competence in basic computer applications, including PDF handling, Excel navigation, and quick adaptation to new systems.
Career Growth Opportunities
Joining our team as a Healthcare Coordinator offers significant opportunities for professional advancement within the healthcare and insurance sectors. You will gain invaluable experience that can lead to further career prospects in various organizational roles.
Company Culture And Values
Our organization fosters a collaborative atmosphere, encouraging employees to contribute their insights and expertise. We uphold high standards of customer service and operational excellence, committed to creating a supportive environment where every team member thrives.
Employment Type: Contractor
