Coordinator, Complaint and Appeals Operations
4 days ago
Description
• responsible for managing to resolution complaint/appeal scenarios for all products • ensure timely, customer focused response to complaints/appeals • identify trends and emerging issues and report and recommend solutions
Requirements
• 1 year experience in HMO and Traditional claim platforms, products, and benefits • patient management, product, compliance and regulatory analysis, special investigations, provider relations, customer service or audit experience • Medicare experience preferred • claims experience preferred • experience in reading or researching benefit language in SPDs or COCs preferred • experience in research and analysis of claim processing a plus
Benefits
• full range of medical, dental, and vision benefits • Company’s 401(k) retirement savings plan • Employee Stock Purchase Plan • fully-paid term life insurance plan • short-term and long-term disability benefits • numerous well-being programs • education assistance • free development courses • CVS store discount • discount programs with participating partners • Paid Time Off (PTO) or vacation pay • paid holidays throughout the calendar year
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