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Grievance & Appeals Coordinator-Medicaid exp

Hybrid in Rancho Cucamonga, CA, US • Posted 6 days ago • Updated 6 days ago

Contract W2

Hybrid

$20 - $25/hr

Fitment

Dice Job Match Score™

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Job Details

Skills

Grievance
Appeals
Grievance and Appeals
Microsoft Word and Excel
and data entry

Summary

JOB DESCRIPTION:

Under the general direction of the Grievance & Appeals Nurse Manager and Grievance Supervisor, the Grievance and Appeals Coordinator is responsible for completing administrative functions and supporting departmental activities for processing Grievance and Appeal cases. The Grievance and Appeals Coordinator is responsible for ensuring that IEHP personnel adhere to the guidelines established and outlined in the IEHP Grievance and Appeals Resolution System. The Grievance and Appeals Coordinator exercises independent judgment to ensure appropriate escalation protocols when trends or deficiencies are identified.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Responsibilities:

Education & Experience

Three or more (3+) years of administrative experience in an office environment, including use of Microsoft Office Suite. Demonstrated superior interpersonal and administrative skills commensurate with years of experience
- Preferred: Experience in a managed care Member Service/Customer Service environment. Prior Medi-Cal and Medicare experience helpful. Previous experience documenting and resolving Member and Provider grievances and appeals
High school diploma or GED required
- Bachelor s degree from an accredited institution preferred

Key Qualifications

Excellent communication and interpersonal skills
Strong organizational skills, typing 45 words per minute, proficient in Microsoft Word and Excel, and data entry experience are essential.
Telephone courtesy
Ability to handle multiple tasks
Strong attention to detail and ability to prioritize work to ensure adherence to task deadlines
Ability to learn and follow standards and procedures
Positive Attitude and ability to work in a team setting

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 90944144
Position Id: 9000432
Posted 6 days ago

Contact the job poster

Sumanth Parikh

Recruiter @ Synkriom

View Profile

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