Grievances Specialist

We are one of the nation's largest oral health care companies, is seeking experienced & Appeals Specialists to join their fast-paced, growing team. You will be expected to provide outstanding customer service; by working independently as well as collaboratively within a team environment. If interested APPLY NOW for this Work from Home opportunity!

salary: $22 - $23 per hour
shift: First
work hours: 8 AM - 4 PM
education: High` School

Responsibilities

What you will do:

• Investigate and resolve complaints and grievances and/or Plan guidelines
• Prepare State Fair Hearing packets and coordinate scheduling of State Fair Hearing reviews
• Assemble necessary information for the plan so they may appropriately investigate member appeals/complaints
• Monitor shared mailboxes and department e-mails to ensure cases are properly entered into the department tracking system, and that requests are acknowledged and resolved timely and accurately
• Contact the involved provider's office to obtain information to properly review the case.

What you will get:

• Work from Home/ Remote
• Competitive Market Pay 
• Flexible Schedule 

What you will do:

• High School Diploma
• 1 year of C&G experience with demonstrated success or 2 years experience in claims, customer service, provider network, or another operational function.
• Proficient with general computer software including Microsoft Excel, Word, and Outlook.
• MUST HAVE OWN EQUIPMENT

Skills

Claims

Insurance Claim Processing

Claims Processing

Qualifications

Years of experience: 1 year

Experience level: Entry Level

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).



For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.