Job Description
TITLE: GRIEVANCE AND APPEALS COORDINATOR ADDRESS: WOODLAND HILLS, CA COIVD: WFH UNTIL OFFICE REOPENS IN SEPT. PAY: $22.00 HOURS : M-F ANYWHERE BETWEEN 8AM-6PM (STAGGERED SHIFTS) CONTRACT TO HIRE
MUST HAVE
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)
OTHER NOTES: • THIS IS NOT AN ENTRY LEVEL POSITION- THIS IS A PRODUCTION BASED DEPARTMENT • NEED STRONG CANDIDATES WHO HAVE CRITICAL THINKING SKILLS AND WRITING SKILL • THIS TEAM DEALS WITH MEMBERS, DOCTORS, INTERNAL MDS, ETC. SO THE COMMUNICATION AND WRITING SKILLS MUST BE ON POINT • THEY WILL BE WRITING FORMAL LETTER RECAPS- THOSE LETTERS MUST BE ACCURATE AND WELL WRITTEN AS THEY END UP IN AUDITS AND WITH CENTENE’S REGULATORS • ISSUES ARE COMING AND OUT EVERY DAY- MUST BE ABLE TO BALANCE A BOOK OF BUSINESS AND MANAGE THEIR WORK
Company Description
In the rapidly-changing, highly regulated industry that is healthcare, you need a medical staffing partner who works for you. Enter TotalMed. We’re an award-winning medical staffing agency delivering flexible healthcare staffing solutions no matter how complex your needs. But even more than that, we’re a team who really cares. Our end goal is to achieve quality patient care while enhancing your employee morale. If you’re a healthcare professional in either clinical or non-clinical healthcare, our recruiters can help you navigate the sea of healthcare jobs, uncovering your ideal career path. Or, if you’re faced with open positions and short-staffed projects in either business care or patient care, TotalMed can provide customized medical staffing solutions to fulfill your hiring requirements.