Grievance & Appeals Coordinator

Overview

Process insurance appeals/grievances, research and respond per regulations

Key Responsibilities

• appeal processing
• case analysis
• research
• customer communication
• regulatory compliance
• project management

Tasks

Process appeals and grievances, analyze, 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 analyzing, 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.

Requirements

• medicare knowledge
• excel
• healthcare degree
• claims analysis
• grievance experience
• research

What You Bring

Letter writing Insurance, Medicare/CMS knowledge Writing Letters Grievance and Appeals experience. Customer Service Experience Experience in analyzing a claim Basic computer skills. How to save a PDF, how to navigate excel, learning new systems Experience in classification between a grievance/appeal/organizational determination. Analytical thinker Degree in Healthcare/computer skills Experience handling a large load of work in a fast-paced environment and have computer skills! Research Skills

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Benefits

Optional Identity theft plan Opportunity for advancement Optional Pre-paid legal plan Voluntary life and disability insurance Page Range Where Required: $32 Medical, dental, vision Long-term assignment with opportunity for hire by client Optional Medical and dependent FSA Work-visa sponsorship Term life Healthcare, English Will this position be required to work onsite for any reason at any time? No, fully remote At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development. It is the policy of Kyyba to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact Kyyba at 248-813-9665

About Kyyba Inc

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Sector Specialisms

Visa Sponsorship

-work-visa sponsorship offered