20 days old

Complaints & Grievances Admin Coordinator

DentaQuest
Milwaukee, WI 53202
  • Job Code
    3421

At DentaQuest, we believe 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 SUMMARY: 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:



  • Facilitate distribution of incoming faxes to appropriate parties within the C&G Department.

  • Maintain inventory of departmental supplies and notify management when additional supplies are necessary.

  • Manage study model inventory and destroy models after denial hold period has expired for MO markets.

  • Assist C&G Specialists in daily scanning of case documentation for Fair Hearing, MAXIMUS and C&G case files.

  • Print/scan/fax documents for TennCare Pick up document handling sheets from specialists and Special Requests Forms and delivering to Intake Department throughout the day Daily pick-up from Specialists and drop-off to Intake of letters that need to be mailed

  • On-site support for representatives working from home to complete critical in-office activities such as scanning, same day print/mail, Federal Express, etc

  • Run the unassigned report and assign cases as directed by C&G management

  • Attach scanned documentation to the C&G case.

  • 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 Specialists with any other tasks necessary in order to complete case timely (e.g., assist with acknowledgements, e-mails, creating e-mail cases, etc)

  • Assist C&G with compiling cases for audit requests, including adding necessary attachment to a case for the purpose of an internal/external audit.

  • 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.

JOB REQUIREMENTS:



  • 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.

PHYSICAL DEMANDS: 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.







Posted: 2021-02-08 Expires: 2021-03-09
Sponsored by:
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Sponsored by:
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Complaints & Grievances Admin Coordinator

DentaQuest
Milwaukee, WI 53202

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