Community Health Plan of Washington
Grievance & Appeals Coordinator I
This job is now closed
Job Description
- Req#: GRIEV002458
Employer Industry: Healthcare Services
Why consider this job opportunity:
- 5% annual incentive target based on company, department, and individual performance goals
- Comprehensive benefits package including medical, dental, vision, and retirement plans with generous employer match
- Flexible work environment with options for telehealth services and flexible spending accounts
- Paid time off starting at 17 days per year, plus additional volunteer and holiday time
- Commitment to diversity and inclusive workforce, promoting an equitable work environment
What to Expect (Job Responsibilities):
- Manage, coordinate, and resolve member and provider complaints, grievances, and appeals
- Conduct thorough investigations of grievances/appeals, ensuring compliance with regulations and policies
- Document all actions taken to resolve grievances/appeals accurately and comprehensively
- Maintain timely documentation and complete files for all grievances/appeals
- Provide guidance and support regarding the grievance/appeal process to stakeholders
What is Required (Qualifications):
- Proficiency in Microsoft Word and Excel
- Ability to meet deadlines established by regulations and contractual obligations
- Strong analytical, written, and verbal communication skills
- Exceptional attention to detail and organizational skills
- Must successfully pass a criminal background check
How to Stand Out (Preferred Qualifications):
- Experience in healthcare-related customer service or complaint resolution
- Familiarity with NCQA standards and regulatory requirements in healthcare
- Ability to collaborate effectively with healthcare providers and stakeholders
- Knowledge of grievance and appeals processes within healthcare settings
#HealthcareServices #GrievanceResolution #CareerOpportunity #DiversityAndInclusion #EmployeeBenefits
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Community Health Plan of Washington puts you at the center of your care, so when your needs change, we change too. That includes expanding our virtual care services, making personal phone calls to check on you, and providing home delivery of your presc...
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