Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
Provide administrative support to the A&G Department including filing, scanning, conduct follow-up calls, setting up initial cases in the Appeals & Grievance module, etc.
Duties and Responsibilities:
Be at work/cubicle timely based on the work schedule on file and ready to handle assignments professionally; must follow company and department guidelines for all time off/vacation/overtime requests.
Processes, researches and responds to members and authorized representatives’ inquiries regarding appeals and grievances received by
phone, fax or mail in accordance with policies and procedures and regulatory guidelines
Responsible for investigating and resolving all priority issues and/or concerns in a timely and efficient manner.
Answers telephone inquiries and maintains a professional level of telephone etiquette.
Responds to any questions from members and authorized representatives regarding appeals and grievances.
Must be able to accomplish duties and assignments with minimal supervision.
Input newly received appeals and grievances in the Appeals & Grievance module
Make follow-up calls to provider offices to request case information as needed
Scan cases into Appeals & Grievance module and associated network drive
Create and maintain member file
Handle department faxing
Check and distribute documents to A&G coordinators
Maintain file systems
File member files/cases based on instruction given
Maintain files and records so they remain updated and easily accessible
Sort incoming mail and prepare outgoing mail (envelope, postage, etc.)
Monitor stocks of office supplies and report when there are shortages
High school GED required
Previous experience in healthcare, customer service or A&G preferred
Bilingual in Chinese, Vietnamese, Korean or Spanish required (speaking and reading; writing preferred)
Proficient knowledge of Microsoft Office
Very good communication, organizational and multi-tasking abilities
Ability to follow directions and perform work independently according to department and senior management standards
Able to function effectively under time constraints
Willingness to accept responsibility and desire to learn new tasks
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.