Grievance & Appeals Coordinator I

Ash Fork, AZ, United States
Arizona Complete Health
26 Current Jobs Openings
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Job Description


You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.Must reside within the state of Arizona. Hours are Monday-Friday, 8am-5pm AZ Time.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\xe2\x80\x99s offices, and claims research.
  • Manage large volumes of documents including copying, faxing and scanning incoming mail
Education/Experience: High school diploma or equivalent. Associate\xe2\x80\x99s degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.Pay Range: $18.66 - $31.73 per hourCentene 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. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Arizona Complete Health

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Job Detail

  • Job Id
    JD4387482
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    $18.66 - 31.73 per hour
  • Employment Status
    Permanent
  • Job Location
    Ash Fork, AZ, United States
  • Education
    Not mentioned
 
 
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