Hybrid Appeals & Grievance Administrative Assistant presso AllCare Health

Appeals & Grievance Administrative Assistant at AllCare Health with the Quality department in Grants Pass, Oregon

We Are Seeking Qualified Candidates to Join Our Team!

AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

Summary

This position is responsible clearing the fax machine and receiving all departmental mail and processing them accordingly by entering new “incidents” into the core claims system for logging and tracking of incoming appeals and grievances by performing the following duties.

Essential Duties

1. Processes all incoming Mail, Faxes, and Emails for Appeals and Grievances. 
2. Creates Customer Service incidents for logging and tacking Appeals and Grievances. 
3. Uploads all appeals and grievance documents in FileBound and generate daily workflow reports for the AGC to process.  
4. Takes meeting minutes for Quality staff meetings and proof reads all minutes typed by the Director of Compliance and Quality.
5. Maintains an extensive knowledge of Medicare, Medicare Part D, Oregon Health Plan rules and regulations and interaction with government counter parts. 

On Call Responsibilities 

This position works on-call one holiday week per year.

Being bilingual in another language, including American Sign Language (ASL), is an invaluable skill that enhances our ability to deliver culturally responsive care. We strongly encourage you to apply if you are bilingual.

All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education.

Education

High school diploma or general education degree (GED) required.

Experience

At least 2 years of related experience and/or training in administrative support, customer service, or healthcare administration.

Certificates, Licenses, and/or Registrations

This position does not require certificates, licenses, and/or registrations.

Technical Skills

• Familiarity with the Healthcare industry.
• Exceptional writing, editing, and proofreading skills.
• Excellent organization and time-management skills.
• Excellent computer skills, including the Microsoft Office Suite (Outlook, Word, PowerPoint, and Excel).
• Knowledge of and compliance with HIPAA regulations.

Interpersonal Skills

• Demonstrate accountability, inspiring trust and confidence from others.
• Negotiate, consider many viewpoints, and settle differences quickly.
• Effectively and professionally communicate with team members and customers.
• Maintain an attentive and empathetic demeanor.
• Maintain a high degree of professionalism and confidentiality.
• Adapt to change, learn quickly, and work with ambiguity.
• Prioritize and organize work according to competing timelines.
• Allocate your time so that you can complete tasks within established deadlines.
• Provide respectful and understanding service to customers within a multicultural environment.

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate

• The employee must be able to work onsite for all scheduled shifts.

Company Overview

AllCare Health Website:  https://www.allcarehealth.com.

AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp® status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at https://bcorporation.net/about-b-corps)

AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more.

The AllCare Health family of businesses is guided by our corporate principles:

Purpose | Working together with our communities to improve the health and well-being of everyone.

Values | Trust, Innovation, Relationships, and Voice.

Vision | Thriving, Inclusive, and Equitable communities.

Brand Promise | Changing Healthcare to Work for You.

AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others. 

If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call 541-471-4106 and ask for Human Resources.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.