Administrative Assistant

• Research and resolve member complaints for all lines of business ensuring compliance with Grievance and Appeals policies and procedures.

• Maintain grievance and appeals case files in the database.

• Effectively communicate with members and providers verbally and in writing.

• Prepare summaries and write resolution letters for members, which includes summarizing member complaints and steps taken to resolve complaints in clear and grammatically correct language.

• Attend and present cases at bi-weekly Staff Grievance and Appeals Committee.

• Prepare files for appeals to regulatory agencies.

• Maintain current on all regulatory requirements as they apply to grievance and appeal processes.