What is the role of a A&G Coordinator at Provider Partners Health Plan?

The A&G Coordinator position at Provider Partners Health Plan is a Full-time or part-time position opportunity in the Admin/Clerical/Secretarial field.

Where is this A&G Coordinator job located?

Remote, Other / Non-US, United States

What type of employment is offered for this A&G Coordinator role?

Full-time or part-time position

What is the expected salary for this A&G Coordinator job?

Compensation will be discussed during the hiring process.

How can I apply for the A&G Coordinator position at Provider Partners Health Plan?

You can apply directly through the application link provided.

A&G Coordinator at Provider Partners Health Plan

A&G Coordinator

The Appeals and Grievances (A&G) Coordinator supports compliance with internal control procedures by assisting with record and report reviews and implementing operating practices. This role serves as the primary liaison for A&G communications between internal and external stakeholders, ensuring timely and accurate coordination of appeals, disputes, and grievance-related correspondence. The A&G Coordinator also assists the A&G Auditor with oversight activities to promote efficient and precise processing of all A&G work.

Primary Duties and Responsibilities

The A&G Coordinator will execute basic administrative duties as defined by the Senior Manager of UM, AG, & Benefit Services, including daily use of appropriate reporting and database systems.
The A&G Coordinator will serve as an A&G liaison between the FDR vendor and the Health Plan.
Develop relationships with FDR vendor to ensure effective communication on process improvements or identified issues.
Assist with the administrative tracking of audits and reporting.
Assist with administrative tasks for updates in policies, procedures, job aides, and other materials to ensure regulatory compliance and implementation.
Participate in audit discussions and shadow A&G Auditor.
Assist A&G Auditor with preparation of audit findings and recommendations.
Assist A&G Auditor with certain audit functions as needed.

Experience Requirements

Prior managed care experience, including knowledge of CMS
Knowledge of ICD 10 and CPT/HCPCS codes and medical terminology
Strong claims, authorizations, and/or appeals workflow processes
Detail-oriented with the ability to perform independently, prioritize multiple tasks, and meet deadlines
Familiarity with healthcare management software, auditing tools, and Microsoft Office Suite (Excel, Word, PowerPoint)
Excellent organizational skills and verbal & written communication skills
Strong people skills with the ability to build relationships and work collaboratively with external partners and internal teams

A&G Coordinator at Provider Partners Health Plan – Remote

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