Appeals & Grievances Coordinator-2

Harvard Pilgrim Health Care Inc

Base: $20.98 - $31.46 ph; bonus/equity: variable p...
Fully remote
Appeals and grievances processing
Regulatory compliance adherence
Mail handling and distribution
Point32Health is seeking an Appeals & Grievances Coordinator to manage the operational aspects of the Appeals and Grievances department. The ideal candidate will have experience in healthcare customer service, excellent organizational skills, and the ability to work independently while adhering to regulatory compliance

Job Summary

  • Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare.
  • The Appeals and Grievance Coordinator is responsible for assisting with all operational aspects of the Appeals and Grievances assignment process in compliance with State and Federal regulations.
  • Point32Health offers a competitive and comprehensive total rewards package including medical, dental, vision coverage, retirement plans, paid time off, and tuition programs.

Matching Summary

Match Score: 75

Point32Health is seeking an Appeals & Grievances Coordinator to manage the operational aspects of the Appeals and Grievances department. The ideal candidate will have experience in healthcare customer service, excellent organizational skills, and the ability to work independently while adhering to regulatory compliance.

Salary

Base: $20.98 - $31.46 per hour; Bonus/Equity: Variable pay eligibility; Benefits: Medical, dental, vision, retirement, paid time off, life and disability insurance

Skills & Requirements

Must-have

  • Appeals and grievances processing
  • Regulatory compliance adherence
  • Mail handling and distribution
  • Data analysis and reporting
  • Medical records coordination
  • Microsoft Excel and Word proficiency
  • Customer service communication

Nice-to-have

  • Knowledge of medical terminology
  • Ability to manage multiple priorities
  • Strong organizational and problem-solving skills
  • Team collaboration and independent work
  • Flexibility to adapt to changing needs
  • Experience with Windows applications

Key Requirements

  • Associate’s Degree or equivalent experience
  • 1-2 years member services/customer service experience
  • Preferred 1-2 years Appeals and Grievance experience
  • Knowledge of regulatory requirements and timeframes

Work Rights

Not specified

Tailored Resume

Cover Letter