grievance appeals coordinator i.west des moines, iowa (remote)posted 1 day ago job detailssummary$22.99 - $23 per hourtemporaryhigh schoolcategoryoffice and administrative support occupations reference AB_5038913 job details

Job Description 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. Associate's degree preferred. 2+ years grievance or appeals, claims or related managed care experience. 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 provider's offices, and claims research.
• Manage large volumes of documents including copying, faxing and scanning incoming mail Years of experience required: preferred:2+ years grievance or appeals, claims or related managed care experience.

oral, written, and problem solving skills. Top 3 must-have hard skills stack-ranked by importance 1 Knowledge about Iowa Medicaid Program and Services 2 Previous call center experience helpfulsalary: $22.99 - $23 per hourshift: Firstwork hours: 8:30 AM - 5

PMeducation:

High SchoolResponsibilities

• 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 provider's offices, and claims research.
• Manage large volumes of documents including copying, faxing and scanning incoming mailSkillsgrievances and appealsProblem Solvingdata entryQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies.

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Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.