Appeals and Grievance Support (Monday-Friday)

PacificSource • Bend, OR

3d • Onsite

About The Position

Provide clerical assistance to the Appeals and Grievance team in the entry and maintenance of case records. This role involves providing high-quality customer service to internal and external customers regarding appeals and grievance inquiries, supporting members, and ensuring customer satisfaction. PacificSource is an equal opportunity employer committed to diversity and inclusion.

Requirements

• Minimum one year customer service, and/or claims processing, health insurance industry process experience required.
• High School Diploma or equivalent required.
• Strong research, analytical and data entry skills.
• Basic math skills.
• Ability to work under strict deadlines.
• Excellent organizational skills.
• Ability to read and comprehend both written and spoken English.
• Communicate clearly and effectively.

Nice To Haves

• Data entry experience preferred.
• Experience using Facets, OnBase, and other software packages used by PacificSource is strongly preferred.

Responsibilities

• Process intake of appeals and grievances into the department's tracking database.
• Monitor incoming documents via fax, web, email, USPS and route to appropriate entity in a timely manner and in accordance with department processes.
• Maintain office supply inventory for the department.
• Communicate complex information related to A&G rules and regulations, verbally and in writing, to internal and external customers.
• Effectively capture and transcribe meeting minutes.
• Work collaboratively in an objective, professional, diplomatic manner with all internal and external customers.
• Provide clerical backup for other A&G staff as needed.
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Benefits

• Our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED