4 Jobs in UNKNOWN, CA
Health Net is Hiring a Remote Grievance & Appeals Coordinator I
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
- Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
- Prepare response letters for member and provider complaints, grievances and appeals
- Maintain files on individual appeals and grievances
- May coordinate the Grievance and Appeals Committee
- Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
- Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
- Manage large volumes of documents including copying, faxing and scanning incoming mail
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Job Summary
Full Time
Insurance
$52k-64k (estimate)
03/22/2024
07/18/2024
healthnet.com
STOCKTON, CA
7,500 - 15,000
1979
CHRIS WING
$1B - $3B
Insurance
Related Companies
About Health Net
Our mission at Health Net is to transform the health of communities, one person at a time. We believe each person deserves quality health coverage, regardless of age, income, job status, or current state of health. We hire individuals who share our mission and passion. Today, our network of 85,000 providers and nearly 3,000 employees are part of the Health Net family across California. We were founded in California more than forty years ago, and are still based in the state today. Health Net now provides coverage to 3 million members thats nearly 1 in every 12 Californians. We have health pla ...
ns for individuals, families, businesses of every size, and people eligible for Medicare and Medi-Cal. Health Net also supports members with access to a variety of programs. These programs offer substance abuse treatment, behavioral health services, and managed health care products related to prescription drugs. We also support our team members through employee assistance programs. Health Net provides these health plans and services through Health Net, LLC and its subsidiaries: Health Net of California, Inc., Health Net Life Insurance Company and Health Net Community Solutions, Inc. These entities are wholly-owned subsidiaries of Centene Corporation (NYSE: CNC). Centene is a Fortune 50 company providing health coverage to more than 20 million Americans. For more information, visit HealthNet.com.
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The following is the career advancement route for Grievance & Appeals Coordinator I positions, which can be used as a reference in future career path planning. As a Grievance & Appeals Coordinator I, it can be promoted into senior positions as an Appeal Resolution Senior Specialist that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Grievance & Appeals Coordinator I. You can explore the career advancement for a Grievance & Appeals Coordinator I below and select your interested title to get hiring information.
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