Appeals and Grievances Intake Analyst

4 days ago

Taguig, National Capital Region, Philippines UST Full time ₱400,000 - ₱600,000 per year

We are searching for an Appeals and Grievances Intake Analyst who will support coordination of appeals and grievances intake, request medical records, and process member/provider requests as well as promote and support Appeals and Grievances team as required.

Responsibilities:

  • Provide support services to team members triaging and completing intake requests for appeals and grievances into system
  • Request medical records or other documentation as needed to complete appeal and grievances
  • Maintain accurate and complete documentation of required information that meets quality standards
  • Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality
  • Perform other duties as assigned

Qualifications:

  • High school diploma or G.E.D. required; associate or bachelor's degree in health care related field an advantage
  • Current unrestricted LPN license or certified Medical Assistant designation an advantage but not required
  • Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor's office, or health insurance company.
  • Appeal and grievance experience preferred.
  • Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required.
  • Computer literacy to include Microsoft Office products
  • Advanced technical skills for use of hardware and software with a high degree of accuracy.
  • Excellent oral and written communication skills for representation of clear and concise results. Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision.
  • Strong time management skills
  • Must possess high degree of accuracy, efficiency, and dependability
  • Effective written and verbal communication and feedback
  • Effective organizational skills with ability to be flexible and prioritize tasks
  • Knowledge of educational assessments and learning strategies
  • Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling in English
Skills

US Healthcare, Communications, Team Collaboration

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