MPF Federal, LLC · 22 hours ago
Customer Service Representative - APPEALS AND GRIEVANCE (INDEXER)
United States
Full-time
Remote
Entry, Mid Level
$15/hr - $17.75/hr
2+ years expMPF Federal, LLC is seeking a Customer Service Representative specializing in Appeals and Grievance. The role involves providing expertise in resolving appeals and grievances while communicating with internal parties and analyzing trends.
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Responsibilities
Responsible for providing expertise or general support to teams in reviewing, researching and investigating, negotiating and resolving all types of appeals and grievances
Communicates with appropriate internal parties regarding appeals and grievance issues, implications, and decisions
May also need to analyze and identify trends for all appeals and grievances
May research and resolve written complex or multi-issue provider complaints submitted by physicians/providers
Works independently
May act as a resource for others
May coordinate others' activities
Qualification
Required
High School Diploma / GED (or higher)
2+ years of healthcare claims benefits experience including researching claim denials
1+ years of experience in a customer service environment
1+ years Claims Appeal experience
Basic Proficiency in Microsoft Excel and Word (ability to create, edit, save, and send)
Knowledge of TRICARE or Medicare (CMS) Policy and Processes
Ability to ask probing questions to identify underlying issues
Ability to think analytically
Time management and organizational skills
Issue resolution skills as well as the ability to interact with internal and external customers
Preferred
Knowledge of TRICARE or Medicare (CMS) Policy and Processes
Benefits
Medical benefits
PTO
Holiday pay
Company
MPF Federal, LLC
MPF Federal is a team of highly experienced professionals dedicated to our clients’ needs.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Ria Moore
Chief Operating Officer
Company data provided by crunchbase