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