Grievance &Appeals Coordinator

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator for a contract opportunity with one of our largest clients!

Candidates should be willing to work on our W2 ONLY.

Job Title: Grievance & Appeals Coordinator

Key Skills:

• Experience handling a large load of work in a fast-paced environment.
• Insurance, Medicare/CMS knowledge
• Customer Service Experience

Role Type: W2 only, No c2c

Duration: 6 months

Location: Detroit, MI

Schedule: Remote

Role Summary:

• Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines.
• Contact customers to gather information and communicate disposition of case.
• Conduct pertinent research to evaluate, respond to, and finalize case.
• Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions.

Education and Qualification:

• High School Diploma or GED required.
• Bachelor s Degree in English, Communications or related field preferred.
• Two (2) years customer service experience required.
• Two (2) years health insurance experience and familiarity with health insurance state and federal regulations preferred.
• Strong project management skills preferred.

Top 3 Required Skills/Experience

• Experience handling a large load of work in a fast-paced environment.
• Insurance, Medicare/CMS knowledge
• Customer Service Experience

Required Skills/Experience

• Writing Letters
• Analytical thinker
• Research Skills
• Multi-task

Preferred Skills/Experience

• Grievance and Appeals experience.
• Degree in Healthcare
• Experience in analyzing a claim
• Experience in classification between a grievance/appeal/organizational determination.

Beware of scams. S3 never asks for money during its onboarding process.

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