Job Description
Required Level of Education and Preferred Level of Education: HS Diploma but bachelor’s is preferred
How many years of related experience are you looking for in your ideal candidate? 6 years customer service. Heavy writing and speaking with customers over the phone. Microsoft excel, word, really help. Healthcare environment is a plus. BlueShield, Aetna, Healthcare providers (this is a huge plus)
Expected Shift: M-F Normal business hours 8:30-5pm with opportunities for overtime.
Interview Process: 1 interview -phone interview (teams is preferred if possible)
Top Daily Responsibilities
Research and respond to member grievances and appeals
Meet regulatory requirements
Improve Member Experience
Top (3) Required Skills Candidate Should Have
Background in grievance and appeals case processing.
Strong organizational and time management skills
Ability to multi-task in a fast-paced environment
Additional Skills Preferred
Strong knowledge of federal & state regulations and Medicare/Medi-Caid regulations.
Ability to compose high quality, detailed written communication.
Excellent interpersonal, verbal and written communication skills.