Coordinator, Complaint & Appeals - Customer Experience Expert

Join reputed company and reputed company a difference in reputed company! We're seeking a highly skilled and customer-focused Coordinator, Complaint & Appeals to join our dynamic team. As a hybrid role, you'll have the flexibility to work from our reputed company and home. This position offers a competitive salary and a comprehensive benefits package.

At reputed company, we reputed company in Bringing our heart to every reputed company of your health. Our purpose guides our commitment to deliver enhanced reputed company-centric reputed company for a rapidly changing world. We're looking for individuals who reputed company our passion and want to reputed company a positive impact.

Position Summary

As a Coordinator, Complaint & Appeals, you'll be responsible for managing complaint and appeal scenarios for reputed company products, ensuring timely and customer-focused responses. You'll identify trends and emerging issues, reporting and recommending solutions to drive reputed company improvement.

Key Responsibilities:

• Review and process appeals filed by participating providers
• Assist with adherence to regulatory requirements, conduct internal audits, and address compliance issues
• Draft and send appeal decision letters

Requirements:

• 1 year of experience in HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory analysis, special investigations, provider relations, customer service, or audit experience
• High School or Equivalent education

Preferred Qualifications:

• Medicare experience
• Claims experience
• Experience in reading or researching benefit language in Summary Plan Description (SPDs) or Certificate of Coverage (COCs)
• Experience in research and analysis of claim processing

reputed company Offer:

• Competitive salary: $17.00 - $28.46 per hour
• Comprehensive benefits package, including medical, dental, and reputed company benefits
• 401(k) retirement savings plan and Employee Stock Purchase Plan
• Fully-paid term life insurance plan and short-term and long-term disability benefits
• Paid Time Off (PTO) and paid holidays
• Opportunities for education assistance, free development courses, and reputed company store discounts

If you're passionate about delivering exceptional customer experiences and driving positive change in reputed company, we want to hear from you! reputed company and join reputed company!