Appeals and Grievances Coordinator (Remote) Job Vacancy in Medix Houston, TX – Latest Jobs in Houston, TX – updated today
Are you looking for a New Job or Looking for better opportunities?
We got a New Job Opening for
Full Details :
Company Name : Medix
Location : Houston, TX
Position : Appeals and Grievances Coordinator (Remote)
Job Description : Job Summary:The Appeals and Grievances Coordinator description is intended to point out major responsibilities within the role, but it is not limited to these items.
This position will help ensure that responds to complaints, grievances, and appeals in a timely, professional, andcustomer-focused manner, and completed according to state and federal regulatory standards. This position will be specificallyresponsible for monitoring, screening and distributing cases to other team members to ensure accurate and timely working bythe Appeals and Grievances team. This position may also assist in the working of cases, depending on incoming volume, andother project based worked assigned to the appeals and grievances team.
RESPONSIBILITIES % OF TIMEMonitor all incoming channels, including email, phone, and fax for new Provider Disputes,updates to current cases, and other inquiries.20%Review and screen new cases for completeness and timeliness. Communicate withproviders for additional information when necessary. 15%Enter and handoff new cases to Provider Dispute analysts to be worked once intake processis complete. 20%Assist in the review and research of dispute cases. Direct to the appropriate personnel, trackupdates and follow up to ensure that resolution has occurred, documentation is complete,required timeframes are met, and proper written communication of the decision hasOccurred. 15%Maintain Provider Dispute case files and include necessary information to log incomingcorrespondences, tracking dispositions, and maintaining timeliness of resolution as requiredby state and federal mandates. 10%Ensures that all information to members, providers, other parties-to-a- dispute, and otherappropriate persons are accurate, consistent, and customer sensitive. 10%Prepare member and provider letters 5%Other duties and responsibilities as assigned. 5%
EDUCATION:
Bachelor’s degree or equivalent work experience preferredThree (3) or more years of experience in health plan operations setting required, preferably in Appeals & Grievances, Provider Disputes, Claims or Health Care Customer Service
Professional Competencies:Detail orientedAbility to quickly learn and navigate new systems and platforms.Comfortable being on the phone with external parties including but not limited to members and providers.Thrive in fast-paced environments and have a passion for extemporary customer service and resolving conflicts.Self-directed, able to prioritize and takes ownership in projects, cases, and workgroups
Job Types: Full-time, Contract
Salary: $17.00 – $19.00 per hour
Schedule:
Monday to Friday
Work Location: One location
This post is listed Under Jobs in general jobs
Post Tags : , Houston, TX, jobs in Houston, TX, Appeals and Grievances Coordinator (Remote) jobs in Houston, TX
Disclaimer : Hugeshout works to publish latest job info only and is no where responsible for any errors. Users must Research on their own before joining any company