Member Rights and Benefits Consultant

Job description

HealthPartners is hiring a Member Rights and Benefits Consultant . This position is responsible for understanding, investigating, presenting, resolving and effectuating the timely resolution of member grievances, dispute resolution process and/or appeals. The consultant may focus on thoroughly investigating member requests, supporting the formal complaint and appeal resolution process, mitigating risk by identifying compliance concerns and/or providing customer service and member education. The consultant makes sure that the outcome is fair, equitable and in alignment with all federal and state regulations and accreditation standards. Develop relationships with internal and external departments in order to effectively resolve member concerns. Each complaint must be documented clearly, thoroughly, timely and accurately on HealthPartners Customer Service System in order to ensure accurate tracking, reporting and outcomes. ACCOUNTABILITIES : The consultant may be responsible for any of the following responsibilities: - Investigate member concern and ensure that all necessary documents are compiled, reviewed and presented to appropriate decision maker. - Research, understand and ensure...