What are the responsibilities and job description for the Appeals Coordinator position at LanceSoft, Inc.?
Engagement Description:
- The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, providers, authorized representatives, and regulatory agencies.
- The Coordinator is expected to analyze the customers concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.
- 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 customers 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 timeframes, 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.
- Bachelors Degree in English, Communication, Health Care Administration, or related field
