layiq
/la·yiq/adjective
worthy; deserving; fitting; suitable.
A role, opportunity, or path that merits attention, time, and pursuit.
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Job opportunity
Specialist, Admin Complaints, Grievances & Appeals
Oscar Health
Atlanta, Georgia, United States
Source: Oscar Health careers · View original posting
Employer job description
From Oscar Health's posting. “We” and “our” refer to the employer.
Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the role:
The CGA Liaison is responsible for the comprehensive management and resolution of complex administrative member or provider grievances and appeals. You will serve as a subject matter expert on non-clinical case resolution, focusing on sensitive member issues such as claims concerns, access barriers, benefits concerns and complex service inquiries. You will drive the resolution process to meet regulatory standards set by the health plan's governing bodies, while promoting member satisfaction and retention.
You will report into our CGA Team Lead.
Work Location:
This is a remote position, open to candidates who reside in: Arizona, Texas, Florida or Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.