Remote Appeals & Grievances Intake Specialist II

Medica; United States; Remote; USD 41.000 - 71.000; Vollzeit

Zusammenfassung

Medica is a nonprofit health plan serving multiple states. The Appeals & Grievances Intake Coordinator II handles intake, case entry, and routing for member and provider appeals, ensuring timely processing and regulatory compliance.

Remote role with strong focus on accuracy and customer service. Candidates should have a health plan background, 1+ year A&G experience, and the ability to prioritize high-volume workloads while maintaining quality.

Qualifikationen

• High School Diploma or equivalent.
• Minimum 1+ years in Appeals & Grievances (A&G) experience on a dedicated team.
• Experience reviewing and classifying appeals or grievances according to guidelines.
• Ability to prioritize and manage a high-volume workload with accuracy.
• Strong attention to detail and regulatory turnaround time assignment.

Aufgaben

• Perform intake, case entry, and routing for A&G correspondence.
• Respond to member and provider inquiries about A&G processes.
• Review and prepare correspondence for accuracy and completeness.
• Support departmental compliance, documentation, and administrative activities.

Kenntnisse

Attention to detail

Case classification

Time management

Customer service

Ausbildung

High School Diploma or equivalent

Jobbeschreibung

Medica is a nonprofit health plan serving multiple states. The Appeals & Grievances Intake Coordinator II handles intake, case entry, and routing for member and provider appeals, ensuring timely processing and regulatory compliance.

Remote role with strong focus on accuracy and customer service. Candidates should have a health plan background, 1+ year A&G experience, and the ability to prioritize high-volume workloads while maintaining quality.