[Hiring] Grievance and Appeals Coordinator @Banner Health

Role Description

As a Health Plans Grievance and Appeals Coordinator, you will play a critical role within Banner Plans & Networks, ensuring the timely intake, review, investigation, and resolution of grievances, appeals, and provider disputes. This is a high-volume, fast-paced position that requires prior knowledge of grievance and appeals processes.

• Research complex claim and service issues.
• Determine appropriate levels of review.
• Coordinate with internal teams and providers.
• Document findings and prepare professional correspondence including acknowledgment and resolution letters.
• Deliver accurate, compliant, and timely resolutions that support both provider satisfaction and business objectives.

In this role, you will primarily be working in a remote setting. CANDIDATES MUST RESIDE IN THE STATE OF ARIZONA TO BE CONSIDERED. Work shifts will be 8:00 a.m.-5:00 p.m. Monday-Friday.

Qualifications

• High school diploma/GED or equivalent working knowledge.
• Two years of work experience in health care related field or experience managing projects/initiatives, or an equivalent combination of education and experience.
• Knowledge of AHCCCS, HCG and/or CMS regulations.
• Knowledge of MS Word, Excel and Microsoft Office Suite required.
• Knowledge of Medical terminology, claims processing guidelines, and CRM & IDX.
• Knowledge of grievance, appeal and claim dispute processes.

Requirements

• Strong interpersonal, organizational and problem-solving skills.
• Strong oral and written communication skills required.
• Ability to work independently ensuring all deadlines/timelines are met.
• Ability to be flexible and work on a variety of projects simultaneously under tight time constraints.
• Strong analytical, critical-thinking and time management skills.
• Strong organizational skills and ability to prioritize multiple tasks daily.
• Ability to quickly identify, summarize and present options to issues which may arise.
• Consistently meet and exceed regulatory reporting requirements for all lines of business.

Benefits

• Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered.
• Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes employment, criminal and education) is required.

Company Description

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare.

• We offer diverse career opportunities, from entry-level to leadership positions.
• We extend our innovation to employment settings by including remote and hybrid opportunities.