Grievance Resolution Specialist - Judge Group
Orange, CA
About the Job
Location: Orange, CA
Salary: $24.00 USD Hourly - $31.00 USD Hourly
Description: Judge Healthcare is currently seeking a Grievance Resolution Specialist in Orange County, CA!
Contract: 6 months
Contact: bkirking@judge.com
Salary: $24.00 USD Hourly - $31.00 USD Hourly
Description: Judge Healthcare is currently seeking a Grievance Resolution Specialist in Orange County, CA!
Contract: 6 months
Schedule: Monday-Friday, 8am-5pm
This job will have the following responsibilities:
Qualifications & Requirements:
This job will have the following responsibilities:
- Maintains adequate information in clients Health’s systems; ensures data collection, summarization, integration, and reporting which includes case creation and management and events/activity tracking.
- Gathers pertinent information regarding the grievances and appeals received, including, but not limited to, member or provider concerns, supporting information related to initial decision-making, new information supporting the grievance or appeal, or supplemental information required to evaluate grievances and appeals within regulatory requirements.
- Evaluates case details, proposes recommendations, or makes decisions as applicable; ensures organization decision is implemented according to the Grievance and Appeals policies and case resolution.
- Develops resolution letters and correspondence to members and providers
Qualifications & Requirements:
- High School diploma or equivalent required.
- 1 year of experience in any of the following areas: Grievances and Appeals, Claims, Regulatory Compliance, Customer Service, or related fields required.
I look forward to hearing from you!
Brittany Kirking - Sr. Healthcare Recruiter
Judge Healthcare
bkirking@judge.com
720-449-7546
Contact: bkirking@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
Source : Judge Group
