Medical Grievance Clerk-Managed Care
- Consulting
- $23 - $24
- San Diego, CA
Part Time/4 day workweek with flexible hours to fit your schedule/Weekly Pay
A bit about us:
Top Managed Care company is bringing on an experienced contractor to help with a 3 month FMLA coverage. You'll work with a great team, on a 4 day work week to help with heavy data entry for provider adds, terms and changes , completing inake form and medical records for member complaints and provider appeals.
1+ year of relevant experience with managed care with a medical group or health plan is required. Associate's Degree required.
This is a fully onsite position, Monday-Thursday, working 20-30 hours week, they are flexible with your working hours between 7am-5pm.
1+ year of relevant experience with managed care with a medical group or health plan is required. Associate's Degree required.
This is a fully onsite position, Monday-Thursday, working 20-30 hours week, they are flexible with your working hours between 7am-5pm.
Why join us?
This is a fully onsite position, Monday-Thursday, working 20-30 hours week, they are flexible with your working hours between 7am-5pm.
Job Details
Duties:
Requirements:
- Completing provider profile for for internal and external health plan notifications of provider adds, terms and changes.
- Complete intake form for each complaint or appeal received from members or providers.
- Request appropriate medical records and assemble for medical review.
- Forward complaint/appeal to Health Plan with supporting documentation within the required time frames.
- Enters all complaint and appeal data accurately into the database.
- Update and distribute provider directories, working with network management and the credentialing coordinator to obtain the most current information.
Requirements:
- Associates Degree
- 1+ year of managed care experience within a medical group or health plan.
- Strong customer service skills with health plan members or providers
- Proficient with MS Office with strong data entry skills
Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance.
Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance.