Appeals & Grievances Coordinator

At Wentworth-Douglass Hospital, we are committed to providing exceptional healthcare services to our community. As the Appeals & Grievances Coordinator, you will play a vital role in ensuring that our patients receive the highest quality of care and service. You will serve as the primary point of contact for all appeals and grievances, working closely with patients, their families, and our healthcare team to resolve any concerns or issues. We are seeking a detail-oriented and compassionate individual with strong communication and problem-solving skills. If you are passionate about advocating for patients and promoting a positive healthcare experience, we encourage you to apply for this rewarding position.

1. Serve as the primary point of contact for all patient appeals and grievances.
2. Communicate and collaborate with patients, their families, and healthcare team members to address and resolve concerns or issues.
3. Maintain a thorough understanding of all hospital policies and procedures related to appeals and grievances.
4. Manage and track all appeals and grievances, ensuring timely and accurate resolution.
5. Conduct investigations and gather relevant information to support the resolution process.
6. Maintain accurate and detailed records of all appeals and grievances.
7. Serve as a patient advocate, ensuring that their rights and needs are met.
8. Implement and promote best practices for handling appeals and grievances.
9. Communicate with insurance companies and other external entities to facilitate resolution.
10. Provide guidance and support to other departments on appeals and grievances processes.
11. Identify opportunities for process improvement and make recommendations to management.
12. Stay informed of industry trends and regulations related to appeals and grievances.
13. Uphold the hospital's commitment to delivering exceptional healthcare services.
14. Demonstrate empathy, compassion, and professionalism when interacting with patients and their families.
15. Adhere to all confidentiality and privacy policies and regulations.

According to JobzMall, the average salary range for a Appeals & Grievances Coordinator in Somerville, MA, USA is between $50,000 and $70,000 per year. This can vary depending on factors such as experience, education, and the specific company or organization hiring for the position.

Wentworth-Douglass Hospital is the Seacoast's leading not-for-profit medical center with comprehensive services including walk-in care & physician practices. Hospital includes 178-bed Magnet® Recognized hospital, several urgent care and walk-in care facilities, multiple testing centers, 36 Wentworth Health Partners primary care and specialty care provider practices, The Works Health and Fitness Center and the Wentworth-Douglass Foundation.