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Grievances and Appeals

Remote, WFM
Role: Grievance And Appeals
Location: Remote
Duration: 8+ Months
Interview Mode: Telephonic/Webx

 Work from Home Requirements(Till COVID):

Candidate will be working within multiple systems to review, research and provide a decision to various types of member grievances in a Medicaid Health Insurance Plan while ensuring compliance with state and federal laws.
Some outbound calls would be required as research to provide grievance decisions
Ability to create accurate written correspondence focused on member/customer satisfaction
Organizational skills including attention to detail, proactive problem solving and multi-tasking in order to meet required client metrics
Analytical and problem solving skills required
Must possess clear, concise and professional written and verbal communication skills
Proficiency to include Microsoft Excel, Word, Outlook and Teams
Ability to work independently as well as in a team environment while working remotely
Knowledge in Healthcare Insurance, medical and prescription claims for Medicaid plans
Ability to meet production and quality goals
Ability to work scheduled hours 8 am to 4:30 pm EST Monday through Friday -possibility of flex schedule once training is complete

Rahul Yadav
(408) 560-3956
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)


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