California Appeals Coordinator
Company: VirtualVocations
Location: Madison
Posted on: February 5, 2025
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Job Description:
A company is looking for an Appeals and Grievances Coordinator
responsible for managing the appeals and grievance process.
Key Responsibilities
Manage and document member and provider appeals and grievances in
compliance with organizational policies and regulatory
standards
Maintain accurate records and ensure timely processing of all
cases
Monitor trends in appeals and grievances to identify issues and
prepare reports for management and regulatory agencies
Required Qualifications
2+ years of administrative experience in a compliance auditing
environment
Familiarity with healthcare regulations, including HIPAA and
CMS
Associate's degree in a relevant field or 3 years of related
experience in lieu of a degree
Knowledge of DMHC, NCQA, and other regulatory bodies preferred
Strong technical proficiency in data analysis and database software
preferred
Keywords: VirtualVocations, Dubuque , California Appeals Coordinator, Other , Madison, Iowa
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