Complaints & Grievances Admin Coordinator
Location: Redmond, Oregon US
Job Number: 1310
The Complaints & Grievances Administrative Coordinator provides various critical components necessary to support day-to-day operational functions while ensuring the proper workflow within the Complaints and Grievances department.
PRIMARY JOB RESPONSIBILITIES:
- Receive all incoming mail for C&G Department. Date/time stamp and sort mail.
- Facilitate distribution of incoming mail and faxes to appropriate parties within the C&G Department.
- Receive and process a variety of requests including the ordering of departmental supplies as requested.
- Manage study model inventory and the return of models after denial hold period has expired for all markets.
- Assist C&G Specialists in daily scanning of case documentation for Fair Hearing, MAXIMUS and C&G case files.
- Enter inquiries and web portals received as requested
- Attach scanned documentation to the C&G case.
- Assist C&G Specialists in scanning original x-ray films into a digital file that are received in C&G Department.
- Assist C&G Specialists with compiling case files for Dental Director review.
- Assist C&G Specialists with compiling case files for Fair Hearings.
- Assist C&G Report and Audit Coordinators with compiling C&G cases for audit requests.
- Data entry of C&G case documentation details, as needed.
- Must ensure that due dates are entered correctly to avoid missing TATs.
- Must ensure that received dates are entered correctly to avoid missing TATs.
- Must ensure that cases are assigned timely and appropriately to avoid missing TATs.
- Represent DentaQuest in a professional manner at all times.
- Provide recommendations for process improvement within the department and/or company.
- Adhere to DentaQuest business processes, policies and expectations.
- Other duties as assigned.
- High School Diploma or equivalent.
- 1 year experience in clerical setting.
- Knowledge of dental terminology.
- Knowledge of general computer software.
- Knowledge of telephone systems.
- Excellent verbal communication skills.
- Ability to prioritize and organize multiple tasks.
- Ability to work independently.
- Ability to remain organized with multiple interruptions.
- Excellent interpersonal skills.
- Required to attend additional training as requested/deemed necessary.
- Incumbent must be able to communicate effectively.
- Requires overall light physical effort (up to 25lbs.)
- Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer).
- Ability to travel or move about within and outside serviced facilities required.
- Incumbent works primarily in either a private or shared office environment.
Webelieve that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system - from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and deliveringmeasurableoutcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Job Number: 4122
Community / Marketing Title: Complaints & Grievances Admin Coordinator
Location_formattedLocationLong: Redmond, Oregon US