Job Description
Below are the Job Details:
· Client : Blue Cross Blue Shield (BCR0002482)
· Job title: Grievance and Appeals (G &A) Coordinator
· Duration : 1-year contract. Evaluation of contract extensions occur every month, and those that work to expectations are renewed consistently. / Might turn into FTE
· Job location : REMOTE
· Shift : This position will be 1st shift
****Pay Rate : Upto $30/hr on W2 based on experience
Job Description
The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies. The Coordinator is expected to analyze the customer's concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions. Appeal Coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information. The Coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer's concerns. The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation time frames, accuracy, and response guidelines. The Coordinator is responsible for staying abreast of products, networks, internal policies, procedures and regulations for the accurate resolution of appeals, complaints, grievances, and inquiries.
Top 3 Required Skills/Experience –
• Excellent written and verbal communication skills. Must be proficient in proofreading, spelling, grammar, punctuation, and math.
• Analytical mindset- having the ability to examine a matter, the facts, contextual information and make an informed decision or implement a reasonable, rationale solution.
• Strong PC application and system skills- having the ability to navigate multiple computer systems and databases.
Required Skills/Experience – The rest of the required skills/experience. Include:
• Ability to apply policies and procedures to arrive at accurate conclusions.
• Ability to analyze, interpret, apply reason and logic, and conduct research to structure a clear and thorough response.
• Ability to work in a fast-paced environment with tight deadlines and high quality standards.
• Problem solving aptitude.
• Accuracy and strong attention to detail.
• Ability to prioritize responsibilities and effectively manage time.
• Ability to work effectively with management and part of a team to meet targets.
• High regard for protecting confidentiality of member, employee, corporate and performance information.
• Previous customer service or concierge experience.
Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Previous health care or health insurance industry experience.
Education/Certifications – Include:
• Bachelor's Degree in English, Communication, Health Care Administration, or related field.
Company Description
About Kyyba:
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
Kyyba is an Equal Opportunity Employer
Benefits:
Major Medical Coverage, including dental and vision
401k
Term life
Short-term disability
Long-term disability
Pre-paid legal plan
Identity theft plan
Medical and dependent FSA
HSA
Paid time off
Paid holidays
Opportunity for advancement
SELECT AWARDS
•\tAn INC 5000 company for 10 years
•\tCorp! Michigan Economic Bright Spots
•\tCrain’s Detroit Business Top Staffing Service Companies in Detroit
•\tTechServe Alliance Excellence Award- IT and Engineering Staffing & Solutions
•\tBest of MichBusiness winner in HR Wizards & Partnerships
•\tMetro Detroit Elite Category: Recruitment, Selection & Orientation for 101 Best & Brightest
•\t101 Best & Brightest Companies to Work for in Michigan
Monday - Friday: 5 pm to 1:30 am.
About Kyyba:\r\nFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development. \r\n\r\nKyyba is an Equal Opportunity Employer\r\n\r\nBenefits:\r\nMajor Medical Coverage, including dental and vision\r\n401k \r\nTerm life\r\nShort-term disability\r\nLong-term disability\r\nPre-paid legal plan\r\nIdentity theft plan\r\nMedical and dependent FSA\r\nHSA\r\nPaid time off\r\nPaid holidays\r\nOpportunity for advancement\r\n\r\nSELECT AWARDS\r\n•\tAn INC 5000 company for 10 years\r\n•\tCorp! Michigan Economic Bright Spots \r\n•\tCrain’s Detroit Business Top Staffing Service Companies in Detroit\r\n•\tTechServe Alliance Excellence Award- IT and Engineering Staffing & Solutions\r\n•\tBest of MichBusiness winner in HR Wizards & Partnerships\r\n•\tMetro Detroit Elite Category: Recruitment, Selection & Orientation for 101 Best & Brightest\r\n•\t101 Best & Brightest Companies to Work for in Michigan\r\n\r\n\t\r\nMonday - Friday: 5 pm to 1:30 am.