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Grievance and Appeal Coordinator / Customer Service

Company: TekwissenGroup
Location: Detroit
Posted on: November 26, 2022

Job Description:

Overview: TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc. Job Description Dept: Grievance & Appeals Coordinator Engagement Description Analyze, investigate, and resolve appeals, complaints, and grievances. Provide comprehensive and thorough responses in compliance with CMS guidelines, state and federal regulations, and accreditations standards. Interact with internal and external customers and subject matter experts to gather information, build a case, and make decision to maintain or reverse appeal or grievance. Analyze and interpret systems data, contract language, regulatory provisions, and apply to casework. Adhere to policies, procedures, and audit standards to remain compliant and audit ready. Top 3 Required Skills/Experience Critical thinking, problem solving, analytical skills Letter writing and proofreading 2 years Customer service/concierge services Required Skills/Experience - The rest of the required skills/experience. Include: PC Applications Excellent verbal and written communication skills Organizational/Time Management 2 years health insurance experience and familiarity with health insurance state and federal regulations Preferred Skills/Experience - Optional but preferred skills/experience. Include: Project Management Education/Certifications - Include: Bachelor's Degree in English, Communications, or related field preferred. TekWissen Group is an equal opportunity/affirmative action Employer (m/f/d/v) supporting workforce diversity. Job Types: Contract, Full-timePay: Up to $34.00 per hourApplication Question(s): How many years of experience do you have in a call center (Out bound or inbound calls)?Are you familiar with CMS guidelines, State and federal regulations? What is your highest education qualification? Hello Team,Kindly post the below job in Indeed, IndeedRecruiter : ANISETTI KARUNARecruiter Email : Job Title : Grievance and Appeal Coordinator / Customer ServiceJCOM ID : 17258Payrate : 34Status : RequestedSkillset: Critical thinking, problem solving, analytical skills Letter writing and proofreading 2 years Customer service/concierge servicesQuestions:How many years of experience do you have in a call center (Out bound or inbound calls)?Are you familiar with CMS guidelines, State and federal regulations?How many years of experience do you have in Health insurance and federal regulations?What is your highest education qualification? How many years of experience do you have in Health insurance and federal regulations? Do you know Letter writing and proof reading? Do you have Bachelors Degree?Work Location: Remote

Keywords: TekwissenGroup, Detroit , Grievance and Appeal Coordinator / Customer Service, Hospitality & Tourism , Detroit, Michigan

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