Remote Grievance & Appeals Coordinator – Kansas

Centene Management Company LLC; EUA; Teletrabalho; USD 27 000 - 45 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible remote/hybrid/field or office

Resumo da oferta

Centene Corp. is seeking a Grievances and Appeals Specialist to analyze verbal and written member and provider complaints, grievances and appeals and help resolve formal grievances.

This remote position requires Kansas residency, with a Monday–Friday schedule 8am–5pm after training. Responsibilities include data entry, preparing response letters, coordinating committees, and supporting HEDIS and pay-for-performance programs.

Qualificações

• High school diploma or equivalent required.
• Associate’s degree preferred.
• 2+ years grievance, appeals, claims or related managed care experience.

Responsabilidades

• Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
• Prepare response letters for member and provider complaints, grievances and appeals
• Maintain files on individual appeals and grievances
• May coordinate the Grievance and Appeals Committee
• Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
• Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research
• Manage large volumes of documents including copying, faxing and scanning incoming mail
• Performs other duties as assigned
• Complies with all policies and standards

Formação académica

High school diploma or equivalent

Associate’s degree preferred

Descrição da oferta de emprego

Centene Corp. is seeking a Grievances and Appeals Specialist to analyze verbal and written member and provider complaints, grievances and appeals and help resolve formal grievances.

This remote position requires Kansas residency, with a Monday–Friday schedule 8am–5pm after training. Responsibilities include data entry, preparing response letters, coordinating committees, and supporting HEDIS and pay-for-performance programs.