Posted 3 months ago
Grievance and Appeals Specialist
AI Summary
Handles customer and provider inquiries in a call center, routing claims and correspondence to the correct departments for resolution.
About this role
Grievance and Appeals Specialist
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Company Job Description/Day to Day Duties:
Candidates here will be working in a call center environment, mainly routing/transferring customer and provider questions in regards to claims to the appropriate departments
Responsibilities include reviewing and routing correspondence received from members, providers and appointed representatives to the correct department for resolution via CCP2 as well as other various internal Humana systems.
Qualifications
Minimum Education/Qualifications/Licensures:
HS Diploma/GED
Healthcare customer service/call center experience
Proficiency with Microsoft Word and Excel
Able to work within metric driven environment
Additional Information
Position pays $11/hour
Shift:
Must be able to work Monday-Friday, including some weekends and overtime
Potential shifts are: Must be okay with all of these shifts.
6:00-2:30, 7–3:30, 8-4:30 or 9-5:30
Skills
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