Medicaid Appeals Coordinator needs 2+ years of grievance or appeals experience
Medicaid Appeals Coordinator requires:
- College degree (minimum of Associates) or equivalent work experience
- 2+ years of grievance or appeals experience
- Ability to effectively relate to a wide range of individuals from a diverse population.
- Excellent customer service skills
- Previous experience demonstrating problem-solving skills.
- Strong organizational and communication skills, oral and written.
- Working knowledge of Eligibility rules and processes and a willingness to gain an understanding of other operational processes
- Ability to work independently.
Medicaid Appeals Coordinator duties:
- Demonstrate strong understanding of Medicaid, CHIP and the Affordable Care Act
- Provide detail documentation regarding the outcome and action of the review.
- Send appropriate communication to client identifying outcome of review.
- Maintain a copy of all outgoing letters in the designated folder
- Work with consumer and other organizations to resolve issues timely, accurately and professionally.
- Conduct daily monitoring and tracking of all incoming work to ensure SLAs are met. .
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