Appeals and Grievances Specialist

Overview

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.  Even in a non-clinical role, Elderplan employees have an opportunity to make a positive impact on the quality of our health plan members' lives.

The MJHS Difference

At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off, including your birthday!
• Affordable and comprehensive medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities

The A&G Specialist will process the department correspondence, incoming and outgoing, and provide back-up support to the A&G Coordinators and Director, in order to insure that grievances and appeals are processed within established regulatory time frames and in accordance with Agency and department standards. The Specialist will open, date-stamp and log all incoming mail; prioritize and distribute correspondence to appropriate individuals; prepare and maintain departmental files; and additional administrative duties as assigned.

Qualifications

• HS diploma or equivalent
• 1 year prior clerical or related experience required, preferably in a Managed Care or Health Care related organization
• MS Word, Excel proficiency

Min

USD $41,000.00/Yr.

Max

USD $44,000.00/Yr.

Compensation: 41000 to 44000 (USD)