Resolution Coordinator - Full-time / Part-time

We have a full-time/part-time opening for a Resolution Coordinator.

Must be able to work various shifts per week.

Resolution Coordinator needed at BCBS through Manpower. Responsible for coordinating and assigning dispositions of Level 1 Appeals, Provider courtesy reviews and Provider coding reviews. Responsible for determining appropriate response letter based on disposition. Assist with internal and external communication related to grievances and appeals. Responsible for initiating the initial data entry into the appropriate tracking systems. Must be knowledgeable of claims system, benefits, and familiar with all lines of business. Participates in identification, problem solving, and improvements in product design, policies and processes affecting Member Rights and Appeals. The Resolution Coordinator is also the forefront of any incoming correspondence to the Appeals unit. This person is responsible for setting the pace of the workflow within the unit. Education/Experience * High School Graduate or GED * 2 years of Healthcare Customer Service or claims experience handling inquiries and/or claims processing OR * 6 months experience in the Appeals department * Able to read and understand claims history, denials, payments, and suspends, and hold codes If you are interested in this position, please respond to the job ad or email your resume to marci.guthrie@manpower.com We look forward to hearing from you soon!