Grievance Specialist Job at Devoted Health
At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, and technology. We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
Job Description
A bit more about this role:
A Grievance Specialist must possess broad understanding of Devoted Health products and benefits as well as regulatory requirements and timeframes. A Grievance Specialist is responsible for the accurate coordination, efficient administration and resolution of grievances and the investigation needed to complete them. A Grievance Specialist will play a key role in building trust with our members and helping Devoted improve every day.
Responsibilities will include:
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Maintain a current knowledge of Devoted Health products, policies and procedures with the ability to relate this information in a clear, concise manner to members, providers, and internal colleagues
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Triage work effectively to ensure member’s issues are appropriately categorized and routed to the correct area for handling
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Correspond with the member to both meet requirements (written acknowledgement and closure letters and telephone contact and documentation as appropriate) and foster deeper trust with our members
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Complete data entry and documentation requirements in multiple systems
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Responsible for meeting all regulatory and department timelines
Attributes to success:
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Detail oriented - the data integrity is very important in this role and all of the documentation that goes with it
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Having the ability to meet our members where they are - in this role you'll be interacting with our members at a time the health care experience has possibly been frustrating for them
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Ability to escalate to others for support when necessary
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Time management is important in this role - getting back to our members in a timely manner is important
Desired skills and experience:
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Experience in Medicare Advantage appeals and grievances
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Bachelor’s degree or equivalent experience in health care, conflict resolution, or related field; Medicare experience required
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Superior investigation, customer service, interpersonal, and problem-solving skills
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Working knowledge of insurance products, policies, procedures, claims process
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Ability to communicate this information to members, providers, employers, and external agencies clearly and concisely
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Strong computer, analytical, written and oral communication skills
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Ability to work independently and as part of a team
Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!
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Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
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