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    Grievance and Appeals Coordinator - Los Angeles, United States - Randstad

    Randstad
    Randstad Los Angeles, United States

    3 weeks ago

    Default job background
    Description
    A trusted client of Randstad's has openings for experienced Grievance and Appeals Coordinators. Must be experienced with grievance and appeals, claim denials, medical terminology and CPT codes. Previous Grievance and Appeals experience preferred. Ability to communicate with providers and members is essential. If interested, please apply with an updated resume.

    salary: $ $22 per hour
    shift: First
    work hours: 8 AM - 6 PM
    education: High School

    Responsibilities
    • Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
    • 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
    • May coordinate the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
    • Assist with HEDIS production functions including data entry, calls to providers offices, and claims research.
    • Manage large volumes of documents including copying, faxing and scanning incoming mail
    Skills
  • Claim Denials
  • CPT Codes
    • Qualifications
  • Years of experience: 1 year
  • Experience level: Experienced
    • Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

    Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

    At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

    Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

    Applications accepted on ongoing basis until filled.

    Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

    We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

    Experience
    • Experienced
    • 1 year
    Education
  • High School (required)
    • #J-18808-Ljbffr
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