Job Description
Job Description
Job Title: Grievance &Appeals Coordinator
Location: Remote
Duration 6+ months
Dept: MA Grievances and Appeal
Will this position be required to work onsite for any reason at any time? No, fully remote
Engagement Description –
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 in order to evaluate, respond to, and finalize case. Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions.
Top 3 Required Skills/Experience –
• Experience handling a large load of work in a fast-paced environment and have computer skills!
• Insurance, Medicare/CMS knowledge
• Customer Service Experience
Required Skills/Experience – The rest of the required skills/experience. Include:
• Writing Letters
• Analytical thinker
• Research Skills
• Multi-task
Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Grievance and Appeals experience.
• Degree in Healthcare/computer skills
• Experience in analyzing a claim
• Experience in classification between a grievance/appeal/organizational determination.
• Letter writing
• Basic computer skills. How to save a PDF, how to navigate excel, learning new systems
Education/Certifications – Include:
• Healthcare, English
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.
Company DescriptionFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
Kyyba is an Equal Opportunity Employer.
Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b
Company Description
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\n\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.\r\n\r\nKyyba is an Equal Opportunity Employer.\r\n\r\nKyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b