Medical Insurance Grievance and Appeals Coordinator

Aurora, CO US

Post Date: 04/27/2018 Job ID: 81618 Industry: Heatlh care Pay Rate: $15Hr - $16Hr

The Grievance and Appeals Coordinator is responsible for Responding, coordinating, and facilitating resolutions to member grievances.  Coordinate member claim appeals processes with the Claims department.

  1. Promptly responds to member grievances. Maintains record of activities through comprehensive documentation within department databases.
  2. Participates in the grievance and appeal process, which includes receiving, logging, tracking, monitoring, resolving, auditing and reporting of member grievances and appeals.
  3. Gathers additional information to facilitate resolution of the grievance and/or appeal.
  4. Ensure grievances and appeals are resolved in a professional, expeditious manner within contractual time limits.

This position is in Aurora, CO. 

Duration: Medical Leave, 4 weeks+

Hours: 8:00am- 5:00pm, Monday - Friday

We are looking to get someone started ASAP.

Top skills:

  • Multi-tasking is a must.
  • Attention to detail.
  • Ability to speak, understand, and communicate the English language effectively. Ability to hear adequately on the phone or in person and group settings.
  • Ability to work in normal office environment conditions and with various office equipment (i.e. computer, keyboard, mouse, calculator, copier, printer, fax, scanner, telephone). Mobility necessary to access various offices and a wide variety of meeting settings.

Knowledge of health care and a strong understanding of grievances.

Prefer candidate who knows Altruista or QNXT systems.

Please forward resumes to denver@stivers.com and refer to job number # 81618.

EOE M/F/D/V


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