Grievance & Appeals Associate in Niagara Falls, NY


Kalos Health Posted: 2021-01-07

Niagara Falls, NY 14304

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Kalos Health is seeking a Grievance & Appeals Associate to join the team. The Grievance and Appeals associate will ensure that a response to complaints, grievances and appeals is completed in a timely and professional manner.

Responsibilities will include:

• Responsible for submission, intervention and resolution of appeals, grievances, and/or complaints
• Responsible for preparing Initial Adverse Determination, Appeal, Final Adverse Determination and other correspondence to Members
• Maintain electronic files of all documentation and appropriate follow up documentation in member and provider memo screens, or other computer system modules or databases as per current workflows.

Requirements:

• Associates degree or equivalent combination of education and experience
• Two (2) years of related experience
• Proficiency in MS Office applications, including Word, Excel and Outlook & program software programs
• Ability to multi-task, adapt to changing priorities, manage a diversity of high priority projects in a fast-paced environment.

The ideal candidate will have excellent communication skills, both verbal and written, as well as being self-motivated and able to meet pressing deadlines with a high attention to detail.

Liberty offers outstanding benefits, including:
Excellent pay and compensation
19 days of paid time off in your first year
Health Insurance starting on your first day
Inexpensive insurance options for medical, dental and vision
Birthday gift
And Much More!!

More information about Kalos Health and this position can be found at the company link below

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