Grievance & Appeals Coordinator

🔥 53 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $21 - $32 / hour

⏱ Part Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Banner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Banner Health is a leading healthcare system committed to making healthcare easier through comprehensive patient services and resources. They provide a safe place for care with services ranging from emergency and urgent care, imaging, and surgery centers to maternity and hospice care. Banner Health also offers telehealth options to ensure access to healthcare, regardless of location. They support athletes through Banner Orthopedics & Sports Medicine and have been recognized for exceptional patient care. With advanced digital tools, they aim to manage healthcare seamlessly for their patients.

📋 Description

• Handle member and provider grievances, appeals and claim disputes • Screen claim disputes for acceptable criteria, including untimely claims and resubmissions • Maintain logs, categorize and track documents, notices and returned receipts • Enter accepted appeals and claim disputes into CRM systems and maintain case files • Ensure appeals and disputes are acknowledged within AHCCCS, HCG and CMS contractual timelines • Respond to phone calls, incoming mail, and member and provider questions • Research and resolve grievance, appeal and claim dispute issues • Create and submit resolution and extension correspondence using applicable regulations and statutes • Gather medical records, coding and claim documentation for reviewers • Report State Fair Hearings at grievance and appeals meetings • Collaborate with internal departments and provide technical expertise on grievance, appeal and claim dispute processes • Self-audit for regulatory compliance

🎯 Requirements

• High school diploma/GED or equivalent working knowledge • Two years of work experience in a health care related field or experience managing projects/initiatives, or an equivalent combination of education and experience • Knowledge of AHCCCS, HCG and/or CMS regulations • Knowledge of MS Word, Excel and Microsoft Office Suite • Knowledge of medical terminology, claims processing guidelines, CRM and IDX • Knowledge of grievance, appeal and claim dispute processes • Strong interpersonal, organizational and problem-solving skills • Strong oral and written communication skills • Ability to work independently and meet deadlines/timelines • Ability to work with various levels of healthcare professionals • Ability to manage multiple projects under tight time constraints • Strong analytical, critical-thinking and time-management skills • Completion of post-offer Occupational Health physical assessment, drug screen and background check required • Must reside in Arizona

🏖️ Benefits

• Remote work setting • Part-time schedule • Registry/Per Diem positions do not have guaranteed hours • No medical benefits package is offered for Registry/Per Diem positions