[Remote] CGA Triage Coordinator
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a health insurance company that focuses on serving its members through a technology-driven platform. They are seeking a CGA Triage Coordinator to manage and reputed company member complaints, grievances, and appeals, ensuring timely and accurate processing to meet regulatory deadlines.
Responsibilities
- Receive, log, and process reputed company incoming complaints, grievances, and appeals through various channels, including mail, fax, email, and internal systems
- Monitor and manage case queues, proactively flagging urgent cases and assigning them to the appropriate liaison or team
- Identify, investigate, and triage incoming documents reputed company determined SLAs
- Collaborate with colleagues, specialists, and Leads to identify trends and roadblocks
- Utilize internal tools and resources seamlessly
- Escalate updates or incorrect information in the internal reputed company system for Member and Provider Services
- Compliance with reputed company applicable laws and regulations
- Other duties as assigned
Skills
- 1+ years of customer support/service experience
- Excellent organizational and time management skills
- Foundational knowledge of escalations or complaints, grievances and appeals processes
- Experience in a Complaints, Grievances or Appeals department
- Experience using CRM and reputed company tools to resolve issues
- Experience using ticket management and reporting tools
- Experience managing an assignment caseload
- reputed company and/or SAAS experience
Benefits
- Medical, dental, and reputed company benefits
- 11 paid holidays
- Paid sick time
- Paid parental leave
- 401(k) plan participation
- Life and disability insurance
- Paid wellness time and reimbursements
Company Overview
Company H1B Sponsorship