Remote Appeals & Grievance Investigator

Acentra Health; Portland (ME); À distance; USD 28 000 - 35 000; Plein temps

Résumé du poste

Acentra Health is seeking an Appeals & Grievance Specialist to conduct investigations and manage outcomes of complaints and appeals. This remote role follows core hours in the Eastern time zone, with responsibilities including triage, correspondence, documentation, and timely resolution in compliance with regulatory and accreditation requirements.

The ideal candidate has a history in customer service, strong communication, and the ability to collaborate in a team-oriented environment, while

Qualifications

• Requires high school diploma or GED; Associate's degree preferred.
• 1+ years' experience in customer service required.
• Proficient in MS Word and Outlook; strong written and verbal communication skills.
• Strong critical thinking, organization, and interpersonal abilities.
• Ability to review cases and ensure correct level of appeal and collaborate effectively.

Responsabilités

• Assign mail cases to the correct area based on appeal level.
• Respond to customers via verbal and written correspondence.
• Document and log inquiry, appeal, and complaint information.
• Resolve cases within required timeframes to meet turnaround deadlines.
• Adhere to HIPAA and privacy/security policies.

Connaissances

Customer service

Communication

Organizational skills

Interpersonal skills

Formation

High school diploma or GED

Associate's degree preferred

Outils

MS Word

Outlook

Description du poste

Acentra Health is seeking an Appeals & Grievance Specialist to conduct investigations and manage outcomes of complaints and appeals. This remote role follows core hours in the Eastern time zone, with responsibilities including triage, correspondence, documentation, and timely resolution in compliance with regulatory and accreditation requirements.

The ideal candidate has a history in customer service, strong communication, and the ability to collaborate in a team-oriented environment, while