Grievance &Appeals Coordinator

Overview :

TekWissen is a global workforce management provider headquartered in Ann Arbor Michigan that offers strategic talent solutions to our clients world-wide. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.

Title : Grievance &Appeals Coordinator

Work Location : Detroit MI 48226

Duration : 6 Months

Job Type : Temporary Assignment

Work Type : Remote

Dept : MA Grievances and Appeals

Engagement Description :

Process appeals and grievances analyse research and provide comprehensive responses in accordance with established regulatory and accreditation guidelines.

Contact customers to gather information and communicate disposition of case.

Conduct pertinent research in order to evaluate respond to and finalize case.

Familiar with standard concepts practices and procedures for analysing interpreting data and applying contract and regulatory provisions.

High School Diploma or GED required.

Bachelor s Degree in English Communications or 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.

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

Required Skills / Experience The rest of the required skills / experience. Include :

Writing Letters

Analytical thinker

Research Skills

Multi-task

Preferred Skills / Experience Optional but preferred skills / experience. Include :

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 systems

Education / Certifications Include :

Healthcare English

TekWissen Group is an equal opportunity employer supporting workforce diversity.

Key Skills

Corporate Risk Management,Electronics,Infection Control,Bakery,ELV,Accident Investigation

Employment Type : Full Time

Experience : years

Vacancy : 1