Commonwealth Care Alliance
Appeals & Grievance Specialist
Commonwealth Care Alliance, Boston, Massachusetts, us, 02298
Employer Industry:
Healthcare Services
Why consider this job opportunity:Opportunity for career advancement and growth within the organizationWork remotely from anywhere within the United StatesSupportive and collaborative work environmentChance to improve member experience and ensure compliance with regulationsEngage in process improvement activities to enhance operations
What to Expect (Job Responsibilities):Process grievances and appeals, ensuring timely resolution and compliance with regulationsProvide accurate and courteous service in response to member complaints via various communication methodsCollaborate with care teams and various departments to manage and resolve member appeals and grievancesAct as a content expert on state and federal grievance and appeal regulationsSupport the maintenance and accuracy of data in the member enrollment database system
What is Required (Qualifications):0-2 years of relevant experienceAssociate's Degree or equivalent experienceExceptional attention to detail and organizational skillsExcellent written and verbal communication skillsProficient in Microsoft Office, including intermediate knowledge of Excel and Word
How to Stand Out (Preferred Qualifications):Fluency in Spanish
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Healthcare Services
Why consider this job opportunity:Opportunity for career advancement and growth within the organizationWork remotely from anywhere within the United StatesSupportive and collaborative work environmentChance to improve member experience and ensure compliance with regulationsEngage in process improvement activities to enhance operations
What to Expect (Job Responsibilities):Process grievances and appeals, ensuring timely resolution and compliance with regulationsProvide accurate and courteous service in response to member complaints via various communication methodsCollaborate with care teams and various departments to manage and resolve member appeals and grievancesAct as a content expert on state and federal grievance and appeal regulationsSupport the maintenance and accuracy of data in the member enrollment database system
What is Required (Qualifications):0-2 years of relevant experienceAssociate's Degree or equivalent experienceExceptional attention to detail and organizational skillsExcellent written and verbal communication skillsProficient in Microsoft Office, including intermediate knowledge of Excel and Word
How to Stand Out (Preferred Qualifications):Fluency in Spanish
#J-18808-Ljbffr