Who we are:
Meridian Health Plan is a family-owned, family-operated company of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in six different states (Michigan, Illinois, Iowa, Indiana, Kentucky, and Ohio).
Our employees work hard, play hard, and give back. Meridian employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, weekly Executive Lunches, and volunteer opportunities.
A Day in the Life of a Grievance and Appeal Nurse Coordinator:
This position is responsible for ensuring that appeal and grievances that are clinical in nature, are handled appropriately within established timeframes, guidelines and protocol for clinical decision-making. Successfully maintains National Committee for Quality Assurance (NCQA), URAC or general accreditation status with regard to appeal and grievance decision letters. Responsible for the writing and final editing of all letters sent out for appeals. This position ensures that each employee that is part of the appeal process meets their timeline with a 100% accuracy rate.
Responsible for handling all clinical aspects of the appeal processes within the department to promote consistency and accuracy within the processes and compliance with NCQA, URAC or general accreditation, regulatory requirements and HIPAA guidelines
What you can bring to Meridian:
What Meridian can offer you:
Meridian is an EEO Employer