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    Grievance and Appeals Coordinator 1 - Los Angeles, United States - Workforce Connections

    Workforce Connections
    Workforce Connections Los Angeles, United States

    4 days ago

    Default job background
    Description

    Job Title:
    Grievance and Appeals Coordinator 1

    2 openings

    Contract Duration: 6+ mont contract with potential to convert to full-time


    Pay Rate:
    $20-22/hr


    Location:
    Remote/Hybrid - must be local to Woodland Hills, CA (may need to come in for meetings)

    Work Hours:
    M-F anywhere between 8am-6pm (staggered shifts) Must accept shift given-no flexibility in schedule.

    Qualifications/Skills Needed

    Must have previous Grievance and Appeals exp

    Analytical and research savvy

    Must have at least 1 year of recent healthcare experience and strong work history

    Strong organization and able to multi-task

    Attendance-must be timely and show up to work

    Medical management, Utilization management, and/or running a doctor's office

    Day To Day Responsibilities Of Role


    Speaking with members, documenting, researching (utilizing different material and navigating through systems, reaching out to providers & members, communicating with internal and external parties), formulating responses in writing to members (writing skills are extremely important for this role), will need to meet deadlines.

    Must be ablto demonostate your ability to handle multiple tasks and balancing the case load. This position has a ton of moving parts. Time management plays a key part in this role.

    Need strong candidates who have critical thinking skills and writing skills,

    this is not an entry level position .

    Performance Expectations

    Candidate has to be available and reachable during all working hours.

    During the new hire training the candidates could be called in to attend an in-person training and the dates/times are not flexible.

    Candidate should adhere to the schedule provided and agreed upon. This department does not provide flexible schedules. Candidate should be able to meet department goals and deadlines. Candidate should be able to work in a team environment, whilst utilizing critical thinking skills. Candidates should have good writing skills.

    Roles That Have Done Well

    Call center experience (being able to multitask and work through various issues)
    G&A experience
    People who have worked in Dr's offices (i.e. billing, talking to members, pulling records), experience dealing with members (problem solving)
    Medical Management/UM
    COORDINATING (coordination of care for patient or member)

    #J-18808-Ljbffr
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