CAG Intake Coordinator
Humera is seeking a full time Complaints and Grievances Intake Coordinator. This position is responsible to receive and process requests for appeals and grievances from members, member representatives, providers, and regulatory bodies. Provide live telephonic access for members, providers and internal customers. Perform case set up and preparation activities for the department.
- Answer incoming calls promptly to assure access for members, providers and internal customers during regular business hours.
- Monitor and retrieve incoming appeal and grievance requests and inquiries from mail, voicemail, fax, Macess CAG queue and email within established parameters.
- Screen, triage and distribute calls or requests for information to the appropriate person, department or organizational contact.
- Contact members/providers as necessary to obtain information required to initiate appeals/grievances and educate on the appeal/grievance process.
- Set up cases and assign to staff following department protocol.
- Other projects and duties as assigned.
- High school diploma or equivalent.
- College degree or post high school education preferred.
- One year of experience working in data entry and telephonic customer service
- Able to use and understand commonly used electronic business office tools
- Experience with insurance operations, member or provider customer service
- Experience with complaint, appeal, and grievance support processes.