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Company Contact Info

  • Rancho Cordova, CA 95742
  • Kristen Devereaux

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Appeals and Grievance Specialist

Kelly Services • Rancho Cordova, CA

Posted 2 months ago

Job Snapshot

Travel - None
$20.00-$20.00 Per Hour
Other Great Industries
Media - Journalism - Newspaper, Health Care, Nurse

Job Description

Kelly Services is recruiting for an Appeals and Grievance Specialist for a premiere insurance provider and Fortune 500 company in Rancho Cordova, CA. You will be working in a luxury and professional environment with an abundance of perks. Pay Rate: $20 hourly Hours: 8AM-5PM Mon-Fri Location: Suncenter Dr., Rancho Cordova Ca 95670 Start Date: ASAP Length of Assignment: 6 months with possibility of contract to hire Responsibilities Include: Gather, analyze and report verbal and written member and provider complaints, grievances and appeals Prepare response letters for member and provider complaints, grievances and appeals Maintain files on individual appeals and grievances May coordinate the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to provider-s offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mail Job Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members Job Requirements: Some experience in managed care preferably with appeals and/or grievance resolution Strong oral, written, and problem solving skills Medical claims processing and business writing experience preferred High School Diploma or GED As a Kelly employee, you'll have access to world-class perks! Don't Hesitate Apply Now! Send your resume to
Job ID: US159TKD_23181715
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