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Job Description
- Req#: J263204
Employer Industry: Health Insurance Services
Why consider this job opportunity:
- Salary up to $32.30
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to work on process improvement initiatives with cross-functional teams
- Engaging role that allows for meaningful contributions to member and provider satisfaction
What to Expect (Job Responsibilities):
- Review inquiries to determine if they meet the definition of a grievance or appeal
- Request and review all relevant documentation and assemble case files
- Coordinate resolution results and communicate investigative findings to all involved parties
- Participate in workgroup meetings to address trends in appeals and grievances
- Support Quality Assurance and other quality committees as needed
What is Required (Qualifications):
- Minimum of 3-5 years of relevant, progressive experience in the area of specialization
- High School Diploma or GED
- Knowledge of multiple processing systems and workflows
- Strong verbal and written communication skills
- Excellent organizational skills
How to Stand Out (Preferred Qualifications):
- Experience in Customer Service or a related field
#HealthInsurance #CareerGrowth #GrievanceResolution #QualityAssurance #CustomerService
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