Intake Specialist Appeal and Grievance - Health Plan
BayCare Health System
**Why BayCare?**
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
**Summary:**
+ Handles and processes customer appeals and grievances in accordance with established guidelines, company policies, and legal regulations.
+ Receive and document customer appeals and grievances via multiple channels (phone, email, online portals) in systems.
+ Ensure accurate and timely processing of all intake information according to company and regulatory standards.
+ Assign cases to the appropriate departments for review and resolution.
+ Serve as the first point of contact for customers who wish to appeal decisions or file grievances, ensuring that their concerns are properly documented and addressed.
+ Prepare reports on the volume and status of appeals and grievances as requested by management.
+ Maintain up-to-date knowledge of all relevant laws and policies.
+ Adhere to deadlines for case resolution and reporting requirements.
**Minimum Qualifications:**
**Required Education:** HS Graduate or Equivalent GED
**Required Experience:**
+ 1 year of experience in Customer Service, Claims, Appeals, or Healthcare Administration.
+ Previous experience in handling Appeals and Grievances is a plus.
+ Knowledge of healthcare or insurance industry regulations is highly desirable.
**Facility:**
BayCare Health System, Tampa Startup-BHS
**Location:** BayCare System Office West
**Status:** Full Time, Exempt: No
**Shift Hours:** Varies
**Shift** : Days
**Weekend Work:** Occasional
**On Call:** No
**How often will this team member be working remotely?** Hybrid
Equal Opportunity Employer Veterans/Disabled
**Position** Intake Specialist Appeal and Grievance - Health Plan
**Location** Clearwater:Park Place | Business and Administrative | Full Time
**Req ID** null
Confirm your E-mail: Send Email
All Jobs from BayCare Health System