Loyola Medicine

Temporary Coordinator remote - Appeals & Grievances - MediGold Health Plan

Loyola Medicine(13 days ago)

OnsiteFull TimeMedior$50,000 - $70,000Customer Service/Claims
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About this role

The Appeals and Grievance Coordinator is responsible for processing and resolving appeals, grievances, and disputes from members and providers within a Medicare Advantage insurance plan. The role involves document management, investigation, compliance, and reporting related to federal regulations, specifically CMS guidelines.

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Required Skills

  • Regulatory Compliance
  • CMS Guidelines
  • Claims Processing
  • Investigation
  • Customer Service
  • Medicare
  • Medical Records
  • Auditing
  • Federal Law
  • Healthcare

Qualifications

  • Bachelor’s Degree

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