Baycare Health System - Clearwater, FL
posted about 2 months ago
Full-time - Entry Level
Clearwater, FL
10,001+ employees
Ambulatory Health Care Services
About the position
The Intake Specialist for Appeals and Grievances at BayCare Health System is responsible for managing and processing customer appeals and grievances in compliance with established guidelines and legal regulations. This role serves as the primary point of contact for customers, ensuring their concerns are documented and addressed effectively. The specialist will also prepare reports on the status of appeals and grievances and maintain knowledge of relevant laws and policies.
Responsibilities
- Handle and process customer appeals and grievances according to established guidelines and legal regulations.
- Receive and document customer appeals and grievances via phone, email, and online portals.
- Ensure accurate and timely processing of all intake information according to company and regulatory standards.
- Assign cases to appropriate departments for review and resolution.
- Serve as the first point of contact for customers wishing to appeal decisions or file grievances.
- Prepare reports on the volume and status of appeals and grievances as requested by management.
- Maintain up-to-date knowledge of all relevant laws and policies.
- Adhere to deadlines for case resolution and reporting requirements.
Requirements
- High School Graduate or Equivalent GED.
- 1 year of experience in Customer Service, Claims, Appeals, or Healthcare Administration.
- Previous experience in handling Appeals and Grievances is a plus.
- Knowledge of healthcare or insurance industry regulations is highly desirable.
