Medix
You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.Job SummaryThe Grievance and Appeals Coordinator will be responsible for member and provider grievance and appeals coordination. This role involves documenting and processing appeals and grievances to ensure timely completion. The Coordinator will also conduct outreach phone calls to provider offices for coordination of services and notify providers about new referrals when there is a change in member eligibility status. This position requires collaboration with health plans, providers, and other entities to fulfill responsibilities effectively. All phone call activities are documented in SharePoint and shared with management.Responsibilities / Job Duties Process grievances primarily driven by email and SharePoint. Organize and prioritize tasks based on urgency and due dates. Follow up on cases and check the group grievance email regularly. Document and track follow-up actions and enter them appropriately. Collaborate with a team of five members and report to the manager of Managed Care Operations.Schedule / ShiftInitial on-site training followed by a hybrid schedule starting at three days in-office and two days remote, potentially adjusting to two days in-office based on performance evaluation.Benefits Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances). Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)). 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1). Short Term Disability Insurance. Term Life Insurance Plan. * We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients. Medix Overview:With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.