Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator with one of our largest clients!

Job Title: Grievance & Appeals Coordinator

Duration: 6 months

W2 contract engagement, NO C2C.

Location: Detroit, MI

Schedule: Remote

Responsibilities:

• Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines.
• Contact customers to gather information and communicate disposition of case.
• Conduct pertinent research in order to evaluate, respond to, and finalize the case.
• Familiar with standard concepts, practices, and procedures for analyzing and interpreting data and applying contract and regulatory provisions.

 Required Skills/Experience:

• Strong project management skills preferred.
• Experience handling a large load of work in a fast-paced environment and have computer skills!
• Insurance, Medicare/CMS knowledge
• Customer Service Experience

Preferred Skills/Experience:

• Grievance and Appeals experience.
• Degree in Healthcare/computer skills
• Experience in analyzing a claim
• Experience in classification between a grievance/appeal/organizational determination.
• Letter writing
• Basic computer skills. How to save a PDF, how to navigate Excel, learning new systems

Education/Certifications

• Healthcare, English,

“Beware of scams. S3 never asks for money during its onboarding process.”