[Hiring] Senior Grievance and Appeals Coordinator @Banner Health

Role Description

In the role of Senior Grievance & Appeals Coordinator, you will utilize your expertise in Grievance & Appeals and Medicare to oversee diverse tasks and responsibilities, guaranteeing seamless departmental operations. Your duties will include:

• Reviewing incoming submissions and addressing urgent matters.
• Conducting thorough case investigations and documentation.
• Maintaining tracking systems.
• Composing responses and decisions.
• Conducting compliance audits.
• Reporting on metrics.
• Leading training sessions.

The position is Remote, with work hours between Monday to Friday, 8:00 a.m. to 5:00 p.m. Availability during some holidays may be necessary for compliance purposes. Residency in Arizona is a requirement for this role to ensure compliance.

Qualifications

• Knowledge, skills, and abilities as normally obtained through the completion of an Associate’s Degree in a Healthcare related field or business.
• Three to four years of grievance and appeal work in a health care environment, or an equivalent combination of education and experience.
• Maintains knowledge of AHCCCS, HCG, and CMS regulations by participating in training, teleconferences, and in-services.
• Strong knowledge of administrative hearing processes for escalated grievances, appeals, and claim disputes.
• Knowledge of Marketing Guidelines for AHCCCS, HCG, and CMS.
• Knowledge of Health Plan policies, health care quality improvement initiatives and best practices, and program planning and project management best practices.

Requirements

• Skill in building and maintaining interpersonal relationships, and preparing and presenting detailed information to ensure understanding for a wide audience base.
• Ability to plan/direct projects, grasp new knowledge and concepts quickly and apply them, and assign workflow and tasks to other employees as needed for training purposes.
• Ability to organize, follow through and report results of interventions, conduct Grievance & Appeals related meetings, workgroups, and committees, and to work cross-functionally across the organization.
• Ability to support Grievance & Appeals Manager’s work with attorneys, representatives, and delegated persons regarding cases at the administrative hearing level.
• Ability to train new Grievance & Appeals coordinators, capable of mentoring trainees through a “buddy system.”
• Skill in developing and managing teams; demonstrated critical thinking in resolving issues and conflicts.

Benefits

• Competitive pay range of $23.16 - $34.74 per hour.
• Comprehensive total rewards package.
• Remote and hybrid work opportunities.