Remote Grievance & Appeals Specialist

Banner Health; Oregon; Hybrid; USD 30.000 - 44.000; Vollzeit

Benefits dieser Stelle

Remote work options

Hybrid opportunities

Zusammenfassung

Banner Health is seeking a Health Plans Grievance and Appeals Coordinator in a remote role. You will manage grievances, appeals, and disputes for members and providers, ensuring timely investigations and communications.

The role requires knowledge of AHCCCS, HCG, CMS rules and strong attention to detail. You will collaborate with multiple teams, maintain CRM case files, and produce compliant correspondence throughout the review process.

Qualifikationen

• High school diploma or equivalent.
• Two years of health care related work experience or project management experience.
• Knowledge of AHCCCS, HCG and CMS regulations.
• MS Word, Excel and Microsoft Office Suite proficiency.
• Strong interpersonal, organizational and problem solving skills.

Aufgaben

• Handle member and provider grievances, appeals and claim disputes.
• Enter accepted appeals and disputes into CRM and maintain case files.
• Ensure timely acknowledgement and correspondence per regulatory timelines.
• Coordinate with internal teams and providers; respond to inquiries and document actions.
• Prepare resolution letters and maintain regulatory compliance.

Kenntnisse

Interpersonal skills

Organizational skills

Problem solving

Written communication

Ausbildung

High school diploma/GED

Tools

MS Word

Excel

Microsoft Office Suite

CRM IDX

Jobbeschreibung

Banner Health is seeking a Health Plans Grievance and Appeals Coordinator in a remote role. You will manage grievances, appeals, and disputes for members and providers, ensuring timely investigations and communications.

The role requires knowledge of AHCCCS, HCG, CMS rules and strong attention to detail. You will collaborate with multiple teams, maintain CRM case files, and produce compliant correspondence throughout the review process.