• Intake Specialist Appeal and Grievance - Health…

    BayCare Health System (Clearwater, FL)


    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 GEDRequired 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, Admin - Non Hospital Related-BHS

     

    Status:** **Full Time, Exempt: No

     

    Shift Hours:** **8:00 AM - 5:00 PM

     

    Weekend Work:** **Occasional

    On Call:** **No

    **How often will this team member be working remotely?** Hybrid - 1 day in office required per week

    Equal Opportunity Employer Veterans/Disabled

    **Position** Intake Specialist Appeal and Grievance - Health Plan

    **Location** Clearwater:Park Place | Business and Administrative | Full Time

    **Req ID** 131922