What are the responsibilities and job description for the Grievance and Appeals Coordinator position at A-Line Staffing Solutions?
Job Description
Job Description
A-Line is now hiring a Hybrid - Grievance and Appeal Coordinator in Alameda, CA. Grievance and Appeal Coordinator in would be working for a Fortune 500 company and has career growth potential.
This would be full time / 40 hours per week.
If you are interested in this Grievance and Appeal Coordinator position, please contact Mia Garrett at [email protected] or 586-422-1209.
Grievance and Appeal Coordinator Compensation
The pay for this position is $33 per hour
Benefits are available to full-time employees after 90 days of employment
A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
Grievance and Appeal Coordinator Highlights
Hybrid role. Expected to work 2 3 days a month in office
Monday Friday 8 : 00a 5 : 00p PST
Grievance and Appeal Coordinator Responsibilities
Thoroughly document the investigation and resolution of each case.
Maintain an accurate and complete appeals / grievance record in the electronic database.
Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC appeal processes.
Ensure compliance with state and federal regulations as they relate to appeal and grievance issues.
Serve as the liaison with other departments to resolve grievance issues.
Ensure timely communication with the Supervisor on all issues having potential risk and or impact on operations.
Engage in special projects as assigned / requested.
Other duties as assigned.
Grievance and Appeal Coordinator Requirements
Ability to manage a caseload of a minimum of 60 cases a month.
Coordinate non-complex grievance activities by receiving, handling, and resolving member issues and operational issues with other organizational staff.
Achieve compliance, quality, and production standards.
Ensure all cases and correspondence are managed in accordance with accreditation, regulatory, contractual compliance, and timeliness standards.
Maintain pertinent documents, case files, and correspondence in an organized, confidential, and secure manner.
Perform ongoing data entry.
Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
HS diploma or equivalent
Grievance and Appeal Coordinator Preferred Qualifications
Associates and / or bachelor’s degree
If you think this Grievance and Appeal Coordinator position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!
Mia Garrett Recruiting Assistant
[email protected] or 586-422-1209
Salary : $33