Role description
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all. We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.
Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.
We are searching for an Appeals and Grievances Intake Analyst who will support coordination of appeals and grievances intake, request medical records, and process member/provider requests as well as promote and support Appeals and Grievances team as required.
- Provide support services to team members triaging and completing intake requests for appeals and grievances into system
- Request medical records or other documentation as needed to complete appeal and grievances
- Maintain accurate and complete documentation of required information that meets quality standards
- Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality
- Perform other duties as assigned
Qualifications:
- High school diploma required; associate or bachelor's degree in health care related field an advantage but not required
- Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor's office, or health insurance company
- Appeal and grievance experience a strong advantage
- Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required
- Computer literacy to include Microsoft Office products
- Advanced technical skills for use of hardware and software with a high degree of accuracy.
- Excellent oral and written communication skills for representation of clear and concise results. Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision.
- Strong time management skills
- Must possess high degree of accuracy, efficiency, and dependability
- Effective written and verbal communication and feedback
- Effective organizational skills with ability to be flexible and prioritize tasks
- Knowledge of educational assessments and learning strategies
- Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling in English
Skills
Healthcare,Ms Office,Communication