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- Grievance and Appeals Coordinator I
Date Posted
Today
New!Remote Work Level
100% Remote
Location
Remote in IN
Job Schedule
Full-Time
Salary
$19 - $32 Hourly
Benefits
Health Insurance Retirement Savings Education Assistance Paid Holidays Paid Time Off
Categories
About the Role
Grievance & Appeals Coordinator I
locations
Remote-IN
time type
Full time
job requisition id
1620866
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
Position Purpose:
Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
- Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
- Prepare response letters for member and provider complaints, grievances and appeals
- Maintain files on individual appeals and grievances
- May coordinate the Grievance and Appeals Committee
- Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
- Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
- Manage large volumes of documents including copying, faxing and scanning incoming mail
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance or appeals, claims, related managed care experience, or relevant experience.
Pay Range: $19.04 - $32.35 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.