What are the responsibilities and job description for the Grievance & Appeals Coordinator - Remote in california position at BCForward?
BCforward is currently seeking a highly motivated Grievance & Appeals Coordinator I for an opportunity in 100% Remote OregonPosition Title: Grievance & Appeals Coordinator I (Remote CA) Location: Woodland Hills, CA, 91367 / Sacramento, CA 95834 OnlyDuration: 12-months Job Type: Contract with potential for extensionShift: Monday through Friday, 8:00 AM–5:00 PM, with overtime as needed, including occasional Saturdays and holidays.Pay Rate: $23.00/hour (W2) Job Description:Grievance & Appeals Coordinator IPosition PurposeAnalyze and resolve verbal and written claims and authorization appeals from providers, and pursue resolution of formal grievances submitted by members.Education & ExperienceHigh school diploma or equivalent (required)Associate’s degree (preferred)2 years of experience in grievances and appeals, claims, or related managed care rolesStrong oral, written, and problem-solving skillsKey ResponsibilitiesGather, analyze, and report verbal and written complaints, grievances, and appeals from members and providersPrepare clear, accurate response letters for member and provider complaints, grievances, and appealsMaintain organized files for individual appeals and grievancesCoordinate the Grievance and Appeals Committee, as neededSupport pay-for-performance programs, including data entry, tracking, organization, and researchAssist with HEDIS production activities, including data entry, provider outreach, and claims researchManage large volumes of documents, including copying, faxing, scanning, and processing incoming mailWork Schedule & OvertimeMonday through Friday, 8:00 AM – 5:00 PMOvertime as neededOccasional Saturdays and holidaysBenefits:BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.Company DescriptionAbout BCforward:Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.BCforward is an equal opportunity employer.
Salary : $23