Grievance & Appeals Coordinator I
Community Health Plan of Washington · Seattle, Washington, US
Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will...
Job description
Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: - Strive to a pply an equity lens to all our work. - Reduce health disparities. - Create an equitable work environment. About the Role: The Grievance & Appeals Coordinator is responsible for the management, coordination and resolution of member and provider complaints, grievances, and appeals, ensuring compliance with state and federal regulatory requirements, contractual arrangements, NCQA standards and Plan policies. To be successful in this role, you: - Possess a High School Diploma, or any combination of academic education, professional training, or work experience. - Have a minimum of (1) year operational experience in a managed health care environment - Have experience with Medicaid and Medicare programs. - Will have prior experience working with grievance/appeal resolution. - Have knowledge of medical terminology and coursework (strongly preferred). - Are comforta...