Description: Under general supervision interacts directly with members who request to file a grievance with the Health Plan. The incumbent will interact directly with management staff, other KHS departments, providers, and the grievance team to investigate and facilitate timely resolution of all grievances by Plan Members.
The distinction of the Grievance Coordinator II is the level of complexity of the grievances and interpretation of policies for which the GCII is responsible. The GCII may perform all of the same duties of the GCI with the addition of the compilation of data for reporting analysis required by the Supervisor or Director of Member Services. The incumbent will have daily and extensive contact with members to resolve issues, interpret policies/procedures, benefits, respond to requests for service, and with providers to obtain information/documentation necessary to resolve member grievances.
Requirements: High School Diploma from an accredited school or equivalent; plus 1 year of college. Spanish speaking preferred. Typing skills of 45 nwpm certificate required within one year of issuance. Four (4) or more years of recent experience in customer service related field with a high degree of problem solving and decision making that include adherence to time frames. Two (2) or more years of experience as a Coordinator I or similar experience. High phone volume inquiry experiences a plus. Excellent written and verbal communication skills are required. Excellent customer service and telephone techniques and etiquette. Health Maintenance Organizations (HMO) required. Possession of valid driver’s license and proof of State required auto liability insurance. Required Travel Up to 15%
We have an excellent benefit package to include: health care, dental, life, 457b and 401a plan, and other supplemental benefits. As a condition of employment, a satisfactory drug test and background check are required. E.O.E