A&Amp

60 jobs near Columbus, OH

The Appeals and Grievances (A amp;G) Coordinator supports compliance with internal control procedures by assisting with record and report reviews and implementing operating practices. This role ...

Manager Position at A amp;W 9935Location: 2204 Pleasant Valley Road, Pleasant Valley, WV, 26554 We are seeking a highly motivated and experienced Manager to join our team at A amp;W 9935 in Pleasant ...

FOOD ASSOCIATE

Pleasant Valley, WV

$13 - $17/hr

Food Associate at A amp;W 9935Location: 2204 Pleasant Valley Road, Pleasant Valley, WV, 26554 We are seeking a dedicated and customer-focused Food Associate to join our team at A amp;W 9935 in ...

FOOD SERVICE LEAD

Pleasant Valley, WV · On-site

$14.50 - $19.75/hr

Food Associate at A amp;W 9935Location: 2204 Pleasant Valley Road, Pleasant Valley, WV, 26554 We are seeking a dedicated and customer-focused Food Associate to join our team at A amp;W 9935 in ...

Aircraft Mechanic - Denver

Denver, CO

$29 - $38/hr

Job title A amp;P Mechanic; [23021 - Aircraft Mechanic I] Job location Denver, CO Reports to Director of Maintenance Job purpose Alpine Air is currently seeking full time A amp;P Mechanics to join ...

Aircraft Mechanic - Fargo

Fargo, ND

$28.25 - $37/hr

Job title A amp;P Mechanic; [23021 - Aircraft Mechanic I] Job location Fargo, ND Reports to Shop Supervisor Job purpose Alpine Air is currently seeking full time A amp;P Mechanics to join the crew at ...

Aircraft Mechanic - Sioux Falls

Sioux Falls, SD

$28.50 - $37.50/hr

Job title A amp;P Mechanic; [23021 - Aircraft Mechanic I] Job location Sioux Falls, SD Reports to Director of Maintenance Job purpose Alpine Air is currently seeking full time A amp;P Mechanics to ...

Audit Senior Associate

Dublin, GA · On-site

$69K - $84K/yr

A matters with a TBS team member, A amp;A Manager, Director, and/or Partner. * Make decisions on routine engagement matters. * Supervise and review the work of Audit Associates. * Coordinate and lead ...

Aircraft Mechanic - Omaha

Omaha, NE

$26.75 - $35.25/hr

Job title A amp;P Mechanic; [23021 - Aircraft Mechanic I] Job location Omaha, NE Reports to Director of Maintenance Job purpose Alpine Air is currently seeking full time A amp;P Mechanics to join the ...

Aircraft Mechanic - Cheyenne

Cheyenne, WY

$27.25 - $35.75/hr

Job title A amp;P Mechanic; [23021 - Aircraft Mechanic I] Job location Cheyenne, WY Reports to Director of Maintenance Job purpose Alpine Air is currently seeking full time A amp;P Mechanics to join ...

Audit Senior Associate

Savannah, GA · On-site

$75K - $92K/yr

A matters with a TBS team member, A amp;A Manager, Director, and/or Partner. * Make decisions on routine engagement matters. * Supervise and review the work of Audit Associates. * Coordinate and lead ...

Audit Senior Associate

Atlanta, GA · On-site

$79K - $97K/yr

A matters with a TBS team member, A amp;A Manager, Director, and/or Partner. * Make decisions on routine engagement matters. * Supervise and review the work of Audit Associates. * Coordinate and lead ...

next page

Showing results 1-20

Full-time

Posted 24 days ago


Job description

The Appeals and Grievances (A amp;G) Coordinator supports compliance with internal control procedures by assisting with record and report reviews and implementing operating practices. This role serves as the primary liaison for A amp;G communications between internal and external stakeholders, ensuring timely and accurate coordination of appeals, disputes, and grievance-related correspondence. The A amp;G Coordinator also assists the A amp;G Auditor with oversight activities to promote efficient and precise processing of all A amp;G work.
Primary Duties and Responsibilities
  • The A amp;G Coordinator will execute basic administrative duties as defined by the Senior Manager of UM, AG, amp; Benefit Services, including daily use of appropriate reporting and database systems.
  • The A amp;G Coordinator will serve as an A amp;G liaison between the FDR vendor and the Health Plan.
  • Develop relationships with FDR vendor to ensure effective communication on process improvements or identified issues.
  • Assist with the administrative tracking of audits and reporting.
  • Assist with administrative tasks for updates in policies, procedures, job aides, and other materials to ensure regulatory compliance and implementation.
  • Participate in audit discussions and shadow A amp;G Auditor.
  • Assist A amp;G Auditor with preparation of audit findings and recommendations.
  • Assist A amp;G Auditor with certain audit functions as needed.
Experience Requirements
  • Prior managed care experience, including knowledge of CMS
  • Knowledge of ICD 10 and CPT/HCPCS codes and medical terminology
  • Strong claims, authorizations, and/or appeals workflow processes
  • Detail-oriented with the ability to perform independently, prioritize multiple tasks, and meet deadlines
  • Familiarity with healthcare management software, auditing tools, and Microsoft Office Suite (Excel, Word, PowerPoint)
  • Excellent organizational skills and verbal amp; written communication skills
  • Strong people skills with the ability to build relationships and work collaboratively with external partners and internal teams