Looking for a qualified individual to fill a contract for:
- the 1 year contract position for a Grievance & Appeals Coordinator Located in Detroit, Michigan. Offered pay rate: $37 hr.
(Applicant submissions end by November 21st at 2:00 pm. However, it is strongly recommended that applicants apply as early as possible.)
Grievance & Appeals Coordinator
Analyze and research cases, applying critical thinking, independent judgment, and business sense to make final determinations on appeals and provide comprehensive responses within regulatory timeframes.
Responsible for handling & responding to customer issues involving sensitive or highly visible issues, such as organ transplants, and referrals received from the Office of Financial and Insurance Regulation (OFIR), News Media, Better Business Bureau, etc.
Conduct managerial-level conferences (MLCs) with members/providers and their representatives for Healthcare underwritten products, and MESSA. Troubleshoot and recommend/implement solutions evolving from appeal/MLC cases. Handle sensitive cases received from Legislative Offices and be a liaison to Governmental Affairs.
Monitor the President’s and Grievance hot-lines and respond to those complaints. Support Regulatory Affairs by providing information/answering case questions that will assist that area in defending the companys position at hearings and external reviews conducted by the Insurance Commissioner.
Attend Administrative Law Judge hearings, testifying as an expert witness.
Assist the Office of the General Counsel in litigation cases and by testifying in court.
Bachelor’s degree required.
Job Types: Full-time, Contract
Salary: $36.00 to $37.00 /hour