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Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all:

Humanity in action, Triumph in hardship, Transformation in health.

Department

Must Be a Colorado Resident

Job Summary

The Grievance and Appeal Intake Coordinator ("Coordinator") works under general supervision and supports the G&A team through gathering grievances and appeals from the SharePoint log, portal submissions, email, phone and fax, inputting complaint and appeal requests within the G & A software platform. Answers the G & A phone line, providing information and assistance.

Essential Functions:

• Processes incoming submissions either by fax, phone, email, portal, or SharePoint Log (40%)
• Responds to all G&A requests, including alignment with plan benefits structure, enrollment policies, and compliance requirements, Communicates in a HIPAA-compliant and professional manner (20%)
• Answers incoming provider and member calls regarding complaints and appeals. (10%)
• Completes documentation of G&A activities in accordance with departmental procedures and in compliance with NCQA and CMS standards. (10%)
• Assigns cases to the Grievance and Appeals Specialist (5%)
• Identifies urgent requests and routes them accordingly (5%)
• Educates the provider with documentation that is needed to submit requests (5%)
• Generates and sends approved Acknowledgment letters within approved scope (5%)

Education:

• High School Diploma or GED required

Work Experience:

• 1-3 years customer service or clerical/administrative experience required

Licenses:
Knowledge, Skills and Abilities:

• Bilingual in Spanish preferred
• Strong attention to detail
• Ability to communicate effectively, both in writing and verbally, has superior decision making and problem solving skills
• Ability to use a variety of software programs including Microsoft Office, claims payer, and medical management systems
• Experience with Windows-based computer programs and ability to use computer for data analysis and data display required

Must Be a Colorado Resident

Shift

Work Type

Salary

Benefits

• Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans

• Free RTD EcoPass (public transportation)

• On-site employee fitness center and wellness classes

• Childcare discount programs & exclusive perks on large brands, travel, and more

• Tuition reimbursement & assistance

• Education & development opportunities including career pathways and coaching

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program 

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

• Respect

• Belonging

• Accountability

• Transparency

All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver?s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.

As Colorado?s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.

Applicants will be considered until the position is filled.

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About Denver Health

Take your career to the next level at Denver Health, where we offer a robust benefits package and endless opportunities for growth. Denver Health is a nationally-ranked, locally-trusted, premier healthcare institution located in the heart of Denver, Colorado.Twenty-five percent of all Denver residents, or approximately 150,000 individuals, receive their health care here. We are known as an integrated health care system that encompasses multidisciplinary academic specialties, a community health system, a level I adult trauma center, pediatric emergency and urgent care center home to Denver Public Health and many of the nation's leaders in medicine.Denver Health is an Equal Opportunity Employer At Denver Health we pride ourselves on our commitment to diversity. Equal opportunity is a fundamental principle of Denver Health. As an equal opportunity employer, Denver Health is committed to recruit, hire, promote and administer all human resource actions in a non-discriminatory manner. Denver Health is committed to providing equal opportunities in all business practices and to all persons regardless of age, race, color, national origin, genetic information, religion, sex, pregnancy, disab...ility, sexual orientation, gender identity, gender expression, marital status or veteran status (collectively “protected status”). Denver Health strives to maintain a work environment that is free from unlawful harassment and discrimination and will not tolerate any such conduct by employees or directed at employees within the scope of their employment. Read the full Human Resources Employee Principles and Practices policy.

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