Appeals and Grievance Support (Monday-Friday)

PacificSource • Bend, OR

4d • 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.

What This Job Offers

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