This job board retrieves part of its jobs from: Toronto Jobs | Emplois Montréal | IT Jobs Canada

Pursue your happiness! Your next job is here!

To post a job, login or create an account |  Post a Job

New

Grievance and Appeals Coordinator

A Line Staffing Solutions

This is a Contract position in Slatington, PA posted October 11, 2021.

Now hiring for a Top Healthcare / Managed Care company in Austin TX 78727 whom are in need of an experienced Grievance and Appeals Coordinator to become a part of the team, for a remote/work from home position to start but will return to in office once safe to return.

Please apply directly for consideration.

Jake Z / jzambutoalinestaffing.com Position will be remote to start but will return in office
– Must live near Austin TX 78727 Pay/Hours: Pay Rate: $18.00 to $20.00 per hour (possible pay increase after 90 days) Hours: Full time – Monday
– Friday 40 hour 9:00 a.m.

– 6:00 p.m.

Job Description: Responsible for interacting with clinical and medical doctors with processing appeals and denials
• Process letters associated with these areas.

Ex.

When a service is deemed denied, if the provider requests an appeal, send out the letter to the member.

• Schedule the reviews with the doctor to determine denial and if the appeals are upheld
• After determination, write letters to explain rational
• Non-clinical team, no credentialing.

Work closely with UM team and medical director teams.

Requirements:
• Medical terminology experience
• Managed care experience helpful
• Work in behavioral health side of things, so any experience with this would be great
• Success with people from larger facilities or hospitals, some medical background that translates well.

Even Dentist office experience
– Why Apply: Company Benefits Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability 401k after 1 year of employment: With employer match and profit sharing GREAT Hours Full-Time Monday through Friday, 40 hours per week – Overtime available paying time and a half over 40 hours worked.

Competitive Pay Rate With possible pay increases after 90 days of employment.

Work Life Balance Growth Potential Concurrent Review, Prior Authorization, Managed Care, Health Plan, Health Insurance, Case Manager, Care Manager, Utilization Review, Utilization Management, STARS, HEDIS, Complex Case Management, CCM, Certified Case Manager, NCQA, URAC, CMS, Medicare, Medicaid, HMO, RN, BSN, MSN, Registered Nurse, Quality Assurance, Quality Improvement