Medicare Grievance Appeals Coordinator

Job Description

Job Description

• Handle grievances and appeals, conduct research, analyze cases, and provide responses per regulatory and accreditation guidelines.
• Contact customers to gather information, communicate case outcomes, and finalize cases.
• Familiar with grievance/appeals processes, classification of grievances, appeals, and organizational determinations.
• Write letters, analyze claims, and apply contract and regulatory provisions.
• High School Diploma or GED required; Bachelor's Degree in English, Communications, Healthcare, or related field preferred.
• Two (2) years of customer service and health insurance experience required, with Medicare/CMS knowledge preferred.
• Strong project management, research, analytical thinking, and multitasking skills required.
• Proficient in basic computer skills, such as saving PDFs, navigating Excel, and learning new systems.
• Experience with grievance and appeals processes and letter writing preferred.

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.

Company Description

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.