Coordinator, Complaint & Appeals

Posted 2024-11-21

💎 Seniority level: Entry, 1 year

📍 Location: AZ - Work from home; Work At Home-Idaho; Work At Home-Mississippi; Work At Home-Oklahoma; Work At Home-Vermont; Work At Home-Georgia; Work At Home-Texas; Work At Home-Minnesota; Work At Home-Alabama; Work At Home-Missouri; Work At Home-California; Work At Home-Oregon; Work At Home-Maine; Work At Home-Washington; Work At Home-Arizona; Work At Home-Illinois; Work At Home-Colorado; Work At Home-Nevada; Work At Home-Delaware; Work At Home-Louisiana; Work At Home-Kentucky

💸 Salary: 17 - 31 USD per hour

🔍 Industry: Health care

⏳ Experience: 1 year

🪄 Skills: Communication SkillsAnalytical SkillsCollaborationMicrosoft ExcelProblem SolvingCustomer serviceMicrosoft OfficeAttention to detailOrganizational skillsTime ManagementWritten communicationMultitaskingDocumentationMicrosoft Office Suite

Requirements:

1 year experience that includes both HMO and Traditional claim platforms, products, and benefits.
Experience in patient management, product, compliance, and regulatory analysis.
Skills in special investigations and provider relations.
Customer service or audit experience is required.

Responsibilities:

Responsible for managing complaint/appeal scenarios for all products, which may contain multiple issues.
Coordinate responses from multiple business units.
Ensure timely, customer-focused response to complaints/appeals.
Identify trends and emerging issues and report them.
Recommend solutions based on identified trends.

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