Grievance & Appeals Coordinator

Elevance Health; Chicago (IL); À distance; USD 31 987 - 47 995; Plein temps

Avantages offerts par ce poste

Comprehensive benefits package

Incentive and recognition programs

401(k) contribution

Résumé du poste

A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high school diploma and have four years of relevant experience. This position offers a salary range of $23.22 to $34.84 per hour, along with a comprehensive benefits package, including equity stock purchase and 401(k) contribution.

Qualifications

• 4 years progressively complex experience working in grievances and appeals or equivalent education/experience.

Responsabilités

• Summarizes and presents essential information for clinical specialists.
• Responds to complaints sent to the Office of the Chairman.
• Ensures resolution to inquiries, grievances, and appeals.
• Contacts members to gather information.
• Generates written correspondence to members and regulatory agencies.

Connaissances

Proficient in computer skills

Formation

HS Diploma or equivalent

Description du poste

Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

• Shift hours: Mon, Tues, Sat, Sun 8:30 am – 7:00 pm CST

Grievance & Appeals Coordinator

Responsibilities

• Summarizes and presents essential information for the clinical specialist or medical/dental director and legal counsel.
• Responds to oral and written complaints sent to the Office of the Chairman, President or Vice President complaints.
• Ensures appropriate resolution to inquiries, grievances and appeals within specified timeframes established by either regulatory/accreditation agencies or customer needs.
• Contacts members to gather information and communicate disposition of case.
• Documents interactions.
• Generates written correspondence to members, providers and regulatory agencies.
• Identifies barriers to customer satisfaction and recommends actions to address operational challenges.
• Pursues ongoing education/training on benefits/services to ensure accurate resolution of grievances and appeals, and overall industry knowledge and development (i.e. HIAA, LOMA, etc.).
• Operates a PC/image station to obtain and extract information.
• Documents information, activities and changes in the database.

Minimum Requirements

• HS Diploma or equivalent
• 4 years progressively complex experience working in grievances and appeals; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Proficient in computer skills preferred.

Location and Compensation

Locations: Illinois

Salary range: $23.22 /hr to $34.84 /hr.

Benefits

Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact [e-mail] for assistance.

Candidate Screening

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.