Appeals & Grievances Coordinator-2

Harvard Pilgrim Health Care Inc

Canton, MA, United States
Base: $20.98 - $31.46; bonus/equity: not specified...
Fully remote
Processing daily mail
Handling outgoing mail
Distribution and classification of cases
The Appeals and Grievance (A&G) Coordinator is responsible for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health, adhering to State and Federal regulations

Job Summary

  • The Appeals and Grievance (A&G) Coordinator is responsible for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health, adhering to State and Federal regulations.
  • Key responsibilities include processing mail, distributing and classifying cases, gathering information, coordinating medical records, tracking, and facilitating information delivery to relevant departments and committees.
  • Point32Health offers a competitive and comprehensive total rewards package including medical, dental, vision, retirement plans, paid time off, and well-being benefits.

Matching Summary

The Appeals and Grievance (A&G) Coordinator is responsible for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health, adhering to State and Federal regulations.

Salary

Base: $20.98 - $31.46; Bonus/Equity: Not specified; Benefits: Medical, dental, vision, retirement, PTO, life/disability insurance, tuition program, well-being benefits

Skills & Requirements

Must-have

  • Processing daily mail
  • Handling outgoing mail
  • Distribution and classification of cases
  • Gathering information from external vendors
  • Coordinating medical record requests
  • Tracking effectuations
  • Facilitating delivery of information

Nice-to-have

  • Community of care culture
  • Inclusion and equal healthcare access
  • Empathy and understanding diverse needs
  • Flexibility to respond to changing needs

Key Requirements

  • Associate’s Degree or equivalent experience
  • 1-2 years member services/customer service experience
  • 1-2 years Appeals and Grievance experience
  • Excellent organizational skills
  • Excellent interpersonal/communication skills
  • Computer skills in EXCEL and WORD
  • Knowledge of basic medical terminology

Work Rights

Not specified

Tailored Resume

Cover Letter