Job Description
Job Description
BCforward is currently seeking a highly motivated Grievance & Appeals Coordinator for an opportunity in Remote who reside in Georgia
Position Title: Grievance & Appeals Coordinator
Location: Remote in Georgia
Expected Duration: 12 months contract or 3 months convert into FTE
Pay Rate: $22.50/hr on w2
Education level: HIGH School/GED or Associates
Anticipated Start Date: ASAP
Shift : 8:00am – 5:00pm EST Monday – Friday
********Remote to Georgia - Candidates must reside in GA**********
Job Description:
- Analyze and resolve verbal and written claims and authorization appeals from providers, and pursue resolution of formal grievances from members.
Education/Experience:
- High school diploma or equivalent required; Associate’s degree preferred.
- 2+ years of grievance or appeals, claims, or related managed care experience.
- Strong oral, written, and problem-solving skills.
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.
- Coordinate the Grievance and Appeals Committee as needed.
- Support pay-for-performance programs, including data entry, tracking, organizing, and researching information.
- Assist with HEDIS production functions, including data entry, provider office calls, and claims research.
- Manage large volumes of documents, including copying, faxing, and scanning incoming mail.
Benefits:
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
Company DescriptionAbout BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.
BCforward is an equal opportunity employer.
Company Description
About BCforward:\r\n\r\nFounded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.\r\n\r\nBCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.\r\n\r\nBCforward is an equal opportunity employer.