This site uses cookies. To find out more, see our Cookies Policy

Member and Provider Appeals/Grievance Coordinator in Dayton, OH at Alto Health Care Staffing

Date Posted: 8/13/2017

Job Snapshot

Job Description

  • Research appeals/grievances to determine validity
  • Log all appeals/grievances upon receipt in Facets
  • Stamp and sort incoming mail and direct or assign as appropriate
  • Route appeals to appropriate clinical personnel after documenting Facets
  • Identify, sort and deliver logged appeals/grievances for processing
  • Print and mail letters on denied appeals
  • Provide support to the department, including filing, printing and copying, including preparation of new case files and State hearing case files
  • Report monthly key statistics for all lines of business to the management team
  • Adhere to all policies and procedures, and ensure all guidelines set by regulatory bodies are followed and met
  • Preform any other job related instructions, as requested

Job Requirements

  • High school diploma or equivalent
  • One or more years of either administrative assistant experience or customer service experience required
  • Intermediate computer skills consisting of Microsoft Excel and Word and Facets
  • Typing, 35 WPM
  • Strong written and communication skills
  • Familiarity of the Health Care Field
  • Proper use of grammar
  • Ability to work in a fast paced environment
  • Adaptable to a constantly changing environment
  • Attention to detail
  • Ability to multitask
  • Ability to work independently and with a team
  • Critical thinking and listening skills
  • Decision making and problem solving skills