Job Description
Grievance and Appeals Specialist – Remote
Location: Any city, OH, US, 99999
Req ID: 19520
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
As a Grievance and Appeals Specialist at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.
Your role in our mission
- Answers telephones and responds to highly complex customer questions and/or forwards call to appropriate personnel.
- Researches customer inquiries and responds to appropriate parties in a timely manner.
- Records calls, processes requests and updates account history with results of inquiry to include proper documentation.
- Performs data entry and matches documents to appropriate accounts to ensure up to date and accurate information.
- Reviews client reports on a weekly basis to ensure data integrity; prepares and submits report to management.
What we’re looking for
- Six or more years of customer service or other telephone experience
- One or more years of Grievance and Appeals experience preferred
- Experience with Medicaid preferred
- Experience working with and skilled in the use of help desk software preferred
- Experience working with organizational functions and personnel