Appeals Coordinator

EPITEC; Detroit (MI); Sur place; USD 50 000 - 70 000; Plein temps

Résumé du poste

A healthcare service company is seeking a G&A Coordinator in Detroit, MI. This role involves processing appeals, grievances, and inquiries from members, requiring strong analytical and communication skills. The ideal candidate will have a bachelor's degree and experience in customer service. You will play a critical role in ensuring accurate and timely case decisions while managing multiple priorities in a fast-paced environment.

Qualifications

• Demonstrated ability to apply policies and procedures accurately.
• Experience working in a fast-paced environment with tight deadlines.
• Strong problem solving aptitude and attention to detail.

Responsabilités

• Process appeals, grievances, complaints, and inquiries from members.
• Analyze customer concerns and conduct necessary research.
• Make accurate case decisions based on gathered information.

Connaissances

Analytical mindset

Excellent written and verbal communication skills

Ability to analyze and conduct research

Formation

Bachelor’s Degree in English, Communication, Health Care Administration

Outils

PC application and system skills

Description du poste

The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies. The Coordinator is expected to analyze the customers’ concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.

Top 3 Required Skills/Experience

• Analytical mindset - having the ability to examine a matter, the facts, contextual information and make an informed decision or implement a reasonable, rationale solution.
• Excellent written and verbal communication skills. Must be proficient in proofreading, spelling, grammar, punctuation, and math.
• Ability to analyze, interpret, apply reason and logic, conduct research; structure a clear and thorough response.

Required Skills/Experience

• Ability to apply policies and procedures to arrive at accurate conclusions.
• Ability to work in a fast‑paced environment with tight deadlines and high quality standards.
• Problem solving aptitude.
• Accuracy and strong attention to detail.
• Ability to prioritize responsibilities and effectively manage time.
• Ability to work effectively with management and part of a team to meet targets.
• High regard for protecting confidentiality of member, employee, corporate and performance information.
• Previous customer service or concierge experience.
• Strong PC application and system skills - having the ability to navigate multiple computer systems and databases.

Preferred Skills/Experience

• Background in writing and/or research.

Education/Certifications

Bachelor’s Degree in English, Communication, Health Care Administration,