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Grievance & Appeals Coordinator
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- Engagement Description –The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies.
- Appeal Coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information.
- The Coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer’s concerns.
- The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation time frames, accuracy, and response guidelines.
- The Coordinator is responsible for staying abreast of products, networks, internal policies, procedures and regulations for the accurate resolution of appeals, complaints, grievances, and inquiries.
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