Grievances and Appeals Triage Specialist

Job not on LinkedIn

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $23 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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SCAN

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1977

🏥 Healthcare

⚕️ Healthcare Insurance

👥 B2C

Healthcare • Healthcare Insurance • B2C

SCAN is a mission-driven healthcare organization focused on reinventing aging by delivering evidence-based, patient-centered care and coverage for older adults. It operates an integrated portfolio including health insurance plans with innovative benefits, in-home and virtual primary care, support programs for caregivers and homebound older adults, and specialized services for vulnerable populations. SCAN also invests in and partners with companies that advance care models and resources to help older adults remain healthy and independent at home.

📋 Description

• Implement, analyze, and continuously improve an ERP system • Focus on CTM and FCR work and tracking • Assess functional requirements and initiate complex installations of ERP technologies meeting interdepartmental needs • Ensure cross-functional access to systems • Use ERP integration methodologies to map business processes to ERP modules, typically with assistance from consultants or vendors • Administer user acceptance testing • Communicate with programmers and specialists regarding file design, testing, debugging, storage, access, and related activities • Document, deliver, and administer training and related materials to end users • Provide system support following implementation when needed • Support SCAN’s Vision and Goals • Perform other duties as assigned

🎯 Requirements

• 0-3 years of related (Grievance and Appeals, and ERP systems) experience • Prior experience in handling CTM and FCR work and tracking on a Medicare Advantage Grievances and Appeals team is highly desirable • Associate's Degree or Technical Degree or equivalent experience • Performs work under direct supervision • Handles basic issues and problems, and refers more complex issues to higher-level staff • Possesses beginning to working knowledge of subject matter • Basic technical skills for functional area • Debugging skills • MS Office (Word, Excel, PowerPoint, Outlook, Teams) • Visio • Basic problem-solving skills • Good communication and interpersonal skills • Background check required

🏖️ Benefits

• An annual employee bonus program • Robust Wellness Program • Generous paid-time-off (PTO) • 11 paid holidays per year • 1 floating holiday • 1 birthday holiday • Excellent 401(k) Retirement Saving Plan with employer match and contribution • Robust employee recognition program • Tuition reimbursement • Inclusive benefits • Equal pay programs • Employee resource groups