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Appeal and Grievance Coordinator Reviewer

Pride Global

  • Phoenix, AZ
  • 6 days ago
  • $18–$20 Per Hour

Highlights

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Numbers & Facts

LocationPhoenix, AZ
IndustryFinancial Services
Salary$18–$20 Per Hour
Company Size100 to 499 employees
Year Founded1983
Websitehttp://prideglobal.com

Description

Pride Health is hiring a Appeal and Grievance Coordinator Reviewer  to support our client's healthcare facility in Phoenix, AZInterested? Apply Today! 
 
Job Details: 
Schedule:  9:00 am to 5:00pm PST
Location:  Phoenix, AZ
Job Type: Contract

Contract Length: 16 weeks
Pay Range:  $18 to $20/hr on W2

*Pay offered is based on experience, expertise, credentialing, and education.  
 
Duties: 
  • Review medical records to determine whether required supporting documentation and information are complete and appropriate.
  • Complete assigned appeals and grievances following required clinical training and competency validation.
  • Maintain current knowledge of medical terminology, claims processing, medical management, and appeal and grievance requirements.
  • Research and assemble medical records, coverage guidelines, claims information, and historical data for MAG staff, Medical Director review, Department of Insurance inquiries, executive inquiries, and legal proceedings.
Requirements: 
Skills/Specialties/Technology:
  • Advanced PC proficiency.
  • Advanced proficiency with word processing, spreadsheet, and database applications.
  • Advanced written communication and letter-writing skills.
  • Experience navigating multiple claims, medical management, pharmacy, or related healthcare systems.
Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity

Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.
 
Fair Chance Employment
Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.
 
Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us. 
 
Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
 
Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.
#PHCNonClinicalZipPrideGlobal and it's affiliates offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity
PrideGlobal and it's affiliates are an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment
PrideGlobal and it's affiliates are a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.

About Company

Pride Global is a minority-owned integrated human capital solutions firm headquartered in New York with operating companies throughout the United States, Canada, India and Brazil. Pride Global companies focus on a diverse array of services including vendor management, payroll programs, business process optimization, and staffing for both direct hire and contingent labor.

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