Sign upLog in

Grievance &Appeals Coordinator

TekWissen LLC

NULL, MI(remote)

Apply
JOB DETAILS
SALARY
$34–$34
SKILLS
Analysis Skills, Communication Skills, Conferences, Customer Support/Service, Detail Oriented, Documentation, English Language, Establish Priorities, Healthcare Administration, Mathematics, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Proofreading, Regulations, Research Skills, Writing Skills
LOCATION
NULL, MI
POSTED
20 days ago
Title: Grievance & Appeals Coordinator
Work Location: Remote
Duration: 7 Months
Job Type: Temporary Assignment
Work Type: Remote
Dept: Office Of The General C
Engagement Description:
  • The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies.
  • The Coordinator is expected to analyze the customer's concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.
  • Appeal Coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information.
  • The Coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer's concerns.
  • The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation timeframes, accuracy and response guidelines.
  • The Coordinator is responsible for staying abreast of products, networks, internal policies, procedures and regulations for the accurate resolution of appeals, complaints, grievances, and inquiries.
Top 3 Required Skills/Experience:
  • Analytical mindset- having the ability to examine a matter, the facts, contextual information and make an informed decision or implement a reasonable, rationale solution.
  • Excellent written and verbal communication skills. Must be proficient in proofreading, spelling, grammar, punctuation, and math.
  • Ability to analyze, interpret, apply reason and logic, conduct research; structure a clear and thorough response.
Required Skills/Experience The rest of the required skills/experience. Include:
  • Ability to apply policies and procedures to arrive at accurate conclusions
  • Ability to work in a fast-paced environment with tight deadlines and high quality standards
  • Problem solving aptitude
  • Accuracy and strong attention to detail
  • Ability to prioritize responsibilities and effectively manage time
  • Ability to work effectively with management and part of a team to meet targets
  • High regard for protecting confidentiality of member, employee, corporate and performance information.
  • Previous customer service or concierge experience (not specifically in a CSR type role)
  • Strong PC application and system skills- having the ability to navigate multiple computer systems and databases
Preferred Skills/Experience Optional but preferred skills/experience. Include:
  • Background in writing and/or research
Education/Certifications Include:
  • English/writing field of study, Health Care Administration or related field, history, Juris Doctorate, etc.

About the Company

T

TekWissen LLC

WE THE TEKWISSEN PEOPLE

TekWissen offers you a broader portfolio of services, industry-leading solutions, and the meaningful innovations that give you greater flexibility and speed to respond to market dynamics, reduced costs and risk to improve enterprise performance, and increased productivity to enable growth.

To keep pace with global market demands, TekWissen keeps its finger on the pulse of change. Our organized approach to guiding a project from its inception to closure. Managing projects is becoming more and more important as we enter the digital era. To cope with the pace that this transition demands, a method is required to manage projects so they can yield quality work, while incorporating efficient use of time and resources.

Project involves identifying which quality standards are relevant to the project and determining how to satisfy them.

It is important to perform quality planning during the Planning Process and should be done alongside the other project planning processes because changes in the quality will likely require changes in the other planning processes, or the desired product quality may require a detailed risk analysis of an identified problem. It is important to remember that quality should be planned, designed, then built in, not added on after the fact.

Capabilities and accomplishments in one TekWissen business enhance the opportunity for success in the others. Put simply, TekWissen's unique combination of attributes promotes success.



COMPANY SIZE
100 to 499 employees
INDUSTRY
Computer/IT Services
FOUNDED
2009
WEBSITE
http://www.tekwissen.com/

Resume Resources

Free Resume TemplatesFree Resume Builder