Are you a seasoned professional with a passion for delivering exceptional customer service and leading high-performing teams? Do you have a strong background in grievance management and a keen eye for detail? If so, we invite you to join careerzynith Healthcare as a Grievance Customer Service Team Lead, where you'll have the opportunity to make a meaningful impact on the lives of our customers and drive business growth.

About careerzynith Healthcare

careerzynith Healthcare is a leading provider of health insurance solutions, dedicated to empowering our customers to make informed decisions about their health and well-being. As a division of careerzynith, we're committed to delivering exceptional service, innovative solutions, and a culture of excellence that inspires our employees to grow and thrive.

Job Summary

As a Grievance Customer Service Team Lead, you'll be responsible for overseeing the execution and performance of our Grievance team, providing guidance, instruction, direction, and leadership to our Grievance Coordinators. You'll work closely with our management team to ensure that our team meets or exceeds production and quality goals, while maintaining compliance with CMS regulations and policies.

Responsibilities

* Manage a team of Grievance Coordinators, providing coaching, counseling, and feedback to ensure they meet or exceed performance expectations

• Deliver training to employees as needed, ensuring new hires have the necessary tools and knowledge to succeed
• Ensure Grievance Coordinators expedite timely requests for information and that cases meet compliance requirements
• Understand and interpret CMS regulations and policies, making critical decisions in support of the business as needed
• Communicate effectively with colleagues to hand-off and pick-up work, ensuring seamless workflow and high-quality results
• Responsible for ensuring that the team meets or exceeds production and quality goals, while maintaining compliance with CMS regulations and policies

Qualifications

* Bachelor's or associate degree in a related field (or equivalent experience)

• 2+ years of experience in a Medicare, Medicaid managed care environment, investigating and resolving grievances
• Experience in clinical practice, appeals & grievances, claims processing, utilization review, or utilization management/case management
• Strong written and verbal communication skills, with the ability to work independently on multiple computer applications, including Microsoft Word and Excel
• Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment
• Ability to work from home occasionally or permanently, with a reliable internet connection (cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload)

Preferred Qualifications

* Experience in a leadership or supervisory role, with a proven track record of success in managing high-performing teams

• Strong analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions
• Experience with CMS regulations and policies, with a strong understanding of the grievance process and appeals procedures

What We Offer

* Competitive hourly rate ($17-$26/hour), depending on experience and geographic location

• Eligibility to participate in an annual bonus plan
• Comprehensive benefits package, including medical, vision, dental, and well-being and behavioral health programs
• 401(k) with company match
• Company-paid life insurance
• Tuition reimbursement
• Minimum of 18 days of paid time off per year and paid holidays

Why Join careerzynith Healthcare?

* Opportunity to make a meaningful impact on the lives of our customers and drive business growth

• Collaborative and dynamic work environment, with a culture of excellence and innovation
• Comprehensive training and development programs, to help you grow and thrive in your career
• Competitive compensation and benefits package, with opportunities for advancement and professional growth

How to Apply

If you're a motivated and results-driven professional with a passion for delivering exceptional customer service and leading high-performing teams, we invite you to submit your application today. Please visit our website to learn more about this exciting opportunity and to apply online. Apply To This Job

Equal Employment Opportunity

careerzynith Healthcare is an equal opportunity employer, committed to diversity and inclusion in the workplace. We welcome applications from qualified candidates of all backgrounds, and are proud to be an advocate for better health through every stage of life. Apply for this job