Appeals and Grievance Coordinator
Houston, TX | Contractor
Pulse Staffing has a contract assignment available for an experienced appeals and grievance coordinator in Southwest Houston.
Duties include: activities related to screening of appeals concerning customer complaints, medical necessity and claims appeals, and the coordination of Grievance and Appeals. The primary responsibility is to manage and coordinate the provider and enrollee grievance/appeals process as well as initiation of Independent Review Organization (IRO) external reviews process as relates to Adverse Determinations based on non-medical necessity. Other job duties as assigned.
Monday - Friday, 8a-5p. 12 week assignment, which has the possibility to extend.
(Medical Staffing / Healthcare / Appeals Coordinator / Grievance Coordinator / Pulse Staffing / Houston)
Requirements: 2 years of recent experience working with medical claims, medical appeals, medical grievances. knowledge of ICD-9/CPT/HCPCS coding methods. high school diploma or GED.