Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for a Grievance &Appeals Coordinator, W2 contract engagement with one of our largest clients!

Job Title: Grievance & Appeals Coordinator

Duration: 6 months

W2 contract engagement, No c2c.

Schedule: Remote

Location: Remote

Top 3 Required Skills/Experience:

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

Engagement Description:

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 the disposition of the 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

• Writing Letters
• Analytical thinker
• Research Skills
• Multi-task

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 system

Education/Certifications:

High school diploma or GED required.
Bachelor’s degree in English, communications, or a related field preferred.
Two (2) years customer service experience required.
Two (2) years health insurance experience and familiarity with health insurance state and federal regulations preferred.
Strong project management skills preferred.

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