Grievance &Appeals Coordinator

Strategic Staffing Solutions; Detroit (MI); Remote; USD 45,000 - 60,000; Full time

Job summary

A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate will have a Bachelor's degree and strong analytical and communication skills. This is a W2 contract engagement lasting 12+ months, with a focus on detail and confidentiality.

Qualifications

• Bachelor's degree required.
• Proficient in English writing, health care administration, or related fields.
• Ability to work in a fast-paced environment.

Responsibilities

• Process appeals, grievances, complaints, and inquiries from members.
• Analyze customer concerns and conduct thorough research.
• Document records detailing steps taken to resolve issues.

Skills

Analytical mindset

Excellent written and verbal communication

Ability to analyze and interpret

Strong PC application skills

Attention to detail

Education

Bachelor's degree

Job description

Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator, a W2 contract engagement with one of our largest clients in Detroit, MI! REMOTE!!

Title: Grievance & Appeals Coordinator

Location: Detroit, MI (Fully Remote)

Duration: 12+ Months

Education/Certifications

• Bachelors degree is required.
• English/writing field of study, Health Care Administration or related field, history, library studies, Juris Doctorate, etc.

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 mat
• Ability to analyze, interpret, apply reason and logic, conduct research, structure a clear and thorough response

Engagement Description

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 customer’s concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions. Appeal coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information. The coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer’s concerns. The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation timeframes, accuracy and response guidelines.

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 (not specifically in a CSR type role)
• 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

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