Grievance and Appeals Coordinator 1.

Immediate need for a talented Grievance and Appeals Coordinator 1. This is a 05+ months contract opportunity with long-term potential and is located in CA(Remote). Please review the job description below and contact me ASAP if you are interested. 

Job ID: 24-41511

Pay Range: $20 - $22/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Gather, analyze, and report verbal and written member and provider complaints, grievances and appeals
• Prepare response letters for member and provider complaints, grievances and appeals
• Maintain files on individual appeals and grievances
• May coordinate the Grievance and Appeals Committee
• Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
• Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
• Manage large volumes of documents including copying, faxing and scanning incoming mail.

Key Requirements and Technology Experience: 

• Key Skills; Grievance and Appeals experience.
• At least 1 year of recent healthcare experience.
• Medical management, Utilization management, and/or running a doctor’s office.
• Must have previous Grievance and Appeals exp
• Analytical and research savvy, good writing skills
• Strong organization and able to multi-task
• Must have at least 1 year of recent healthcare experience and strong work history      
• Medical management, Utilization management, and/or running a doctor’s office
• High School Diploma or GED
• Microsoft Office: Outlook, Word, and Excel 

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. 

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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