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SCAN
SCAN
1.001 – 5.000 Angajați
Sponsor pentru viza H1BAsigurare de sănătateAsistență medicalăB2C
SCAN este o organizație de asistență medicală orientată către o misiune, dedicată sprijinirii persoanelor vârstnice pentru a trăi o viață mai sănătoasă și mai independentă. Înființată în 1977, organizația combină asigurarea de sănătate cu servicii bazate pe dovezi și centrate pe pacient, inclusiv asistență medicală primară la domiciliu și virtuală, sprijin pentru îngrijitori, programe pentru adulții imobilizați la domiciliu și îngrijire specializată pentru populațiile vulnerabile. SCAN colaborează, de asemenea, cu organizații care dezvoltă noi modele de îngrijire și resurse pentru îmbătrânirea la domiciliu și investește în acestea.
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Locurile de muncă ale companiei

Grievances and Appeals Coordinator – Medicare Part C and D | SCAN

Coordinate Medicare Part C and D grievance resolution and support members and service teams at SCAN, a nonprofit health organization serving older adults.

USStatele Unite ale AmericiiCACalifornia
20 $ – 29 $ / oră
HibridNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăGeneral

Descriere

  • Lead Member Services Representatives who assist members and related individuals and groups.
  • Handle Medicare Part C and D grievances through resolution.
  • Respond to member inquiries and connect members with appropriate service providers.
  • Apply procedures to verify member identity, enrollment status, and eligibility for services.
  • Keep membership databases and records accurate and up to date.
  • Recommend service or program changes based on member feedback and coverage gaps.
  • Support member retention or renewal efforts as needed.
  • Advance SCAN’s vision and goals.
  • Carry out other assigned duties.

Cerințe

  • 0–3 years of related experience handling grievances and appeals for a health plan, healthcare provider, or managed care organization.
  • Current or previous experience resolving Medicare Part C and D grievances is highly desirable.
  • High school diploma or equivalent experience required.
  • Comprehensive knowledge of grievance and appeals matters.
  • Customer service skills.
  • Ability to work with minimal supervision.
  • Ability to manage complex issues and refer only the most complex cases to higher-level staff.
  • Ability to lead, coach, or mentor a subordinate group; may serve as a lead or first-level supervisor.
  • Basic technical skills relevant to the role.
  • Advanced Microsoft Office skills, including Word, Excel, PowerPoint, Outlook, and Teams.
  • Experience with IKA, MHK, or QNXT preferred.
  • Basic problem-solving skills.
  • Strong communication and interpersonal skills.
  • Background check required.

Beneficii

  • Annual employee bonus program.
  • Wellness program.
  • Generous paid time off.
  • Eleven paid holidays each year.
  • One floating holiday.
  • One birthday holiday.
  • 401(k) retirement savings plan with employer match and contribution.
  • Employee recognition program.
  • Tuition reimbursement.
  • Inclusive benefits.
  • Equal employment opportunity and affirmative action workplace.

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