Grievance & Appeals Coordinator I

Grievance & Appeals Coordinator I

BCForward is currently looking for Grievance & Appeals Coordinator located at Florida, FL 99999 Remote.

**Job Title: Grievance & Appeals Coordinator**

**Location: Florida, FL 99999 Remote.**

**Duration: 3 Months Possible to Extend.**

**Pay rate:

- $24.00 an hour on W2.**

**Position Purpose**:

- Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

**Education/Experience**:

- High school diploma or equivalent.
- Associates degree preferred.
- 2+ years grievance or appeals, claims or related managed care experience.
- Strong oral, written, and problem solving skills.
- Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
- Prepare response letters for member and provider complaints, grievances and appeals
- Maintain files on individual appeals and grievances
- May coordinate the Grievance and Appeals Committee
- Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
- Assist with HEDIS production functions including data entry, calls to providers offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mail.

**Employee Type**: Contractor

**Location**: Florida, OH (Onsite)

**Job Type**: Health Care

**Experience**: Not Specified

**Date Posted**: 11/09/2023