Appeals and Grievance Support (Monday-Friday)

PacificSourceSpringfield, OR
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, and supporting members to ensure customer satisfaction. The position is Monday-Friday.

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

  • PacificSource values the diversity of our community, including those we hire and serve.
  • We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
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