Offer summary
Qualifications:
High School Graduate or equivalent, 1-2 years experience in managed care, Knowledge of Managed Care UM procedures, Familiarity with medical terminology and coding, Proficient with Microsoft applications and EZCAP.
Key responsabilities:
- Facilitate member grievance and appeal process
- Investigation and resolution of appeals and grievances
- Compose correspondence to health plans and handle calls
- Document and maintain data regarding grievances/appeals
- Perform surveys and request records as needed