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Appeals Processing Lead Representative
Ref No.: 19-07220
Location: Phoenix, Arizona
Appeals Processing Lead Representative

Address: 25500 N Norterra Parkway, Building B, Phoenix, AZ 85085
Hours: Monday-Friday, 8:00AM-5:00PM, overtime upon request
Contract Length: 11/25/2019 to 02/28/2019 (possible extension based on attendance and performance)
Openings: 1

Overview:
  • The Appeals Processing Lead Representative is responsible for intake, processing of oral and possibly written grievances, conducting root cause analysis as needed, creating an action plan, coordinating and communicating resolutions, as well as documenting systems in detail with case notes related to Customer grievances.
Skills:
  • Excellent oral, written communication skills & critical thinking ability required
  • Ability to track and manage case load effectively in call tracking system
  • Must be able to work independently and under pressure related to tight time-frames
  • Problem solving skills required
  • Working knowledge of MS Word, Excel and the ability to pick-up and work in multiple computer systems is required
  • Customer-centric mindset 
  • Preferred Requirements:
  • Prior Medicare Advantage background preferred.
  • Call center, Grievances or Appeals department experience preferred.
Competencies:
  • Documenting
  • Microsoft Excel, Word
  • Medicare, Medicaid knowledge
  • Problem solving
  • Root cause analysis
Education:
  • Education High School Diploma or equivalent required
  • At least 1-year experience within the health insurance industry required
  • Ability to pass 7-year county background check and urine drug screen