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Grievance and Appeal Coordinator
Grievance and Appeal CoordinatorTap Growth ai • Detroit, MI, US
No longer accepting applications
Grievance and Appeal Coordinator

Grievance and Appeal Coordinator

Tap Growth ai • Detroit, MI, US
1 day ago
Job type
  • Full-time
Job description

Be among the first 25 applicants

We're Hiring : Grievance and Appeal Coordinator!

Location : Detroit, MI

Role : Grievance and Appeal Coordinator

Duration : 6 months

The Grievance and Appeals (G&A) Coordinator processes appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies. The Coordinator analyzes customer concerns, conducts research using internal and external resources, and makes accurate case decisions. Managerial-level conferences with customers and authorized representatives are coordinated to gather and relay information. Accurate documentation records detailing actions taken to resolve customer concerns are maintained. Outcomes and resolutions of all appeals, grievances, complaints, and inquiries are communicated via written correspondence that satisfies corporate, regulatory, and accreditation time frames, accuracy, and response guidelines. The Coordinator stays abreast of products, networks, internal policies, procedures, and regulations to resolve appeals, complaints, grievances, and inquiries accurately.

Top 3 Required Skills / Experience

  • Excellent written and verbal communication skills. Proficiency in proofreading, spelling, grammar, punctuation, and math.
  • Analytical mindset – ability to examine a matter, facts, contextual information, and make an informed decision or implement a reasonable, rational solution.
  • Strong PC application and system skills – ability to navigate multiple computer systems and databases.

Education / Certifications

  • Bachelor's Degree in English, Communication, Health Care Administration, or related field.

    • Required Skills / Experience

  • Apply policies and procedures to arrive at accurate conclusions.
  • Analyze, interpret, apply reason and logic, and conduct research to structure a clear and thorough response.
  • Work in a fast-paced environment with tight deadlines and high-quality standards.
  • Problem-solving aptitude.
  • Accuracy and strong attention to detail.
  • Prioritize responsibilities and effectively manage time.
  • Work effectively with management and as 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.

    • Preferred Skills / Experience

  • Previous health care or health insurance industry experience.

    • Ready to make an impact? ?? Apply now and let's grow together!

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    Appeal And Grievance • Detroit, MI, US