Medicare Grievance Support SOB
Freelancing PhilippinesJob Description
- Grievance Handling:
o Investigate and resolve member grievances related to Medicare Part D drug coverage, claims, and pharmacy issues
o Ensure all grievances are resolved within required CMS timelines and documented appropriately
- Communication:
o Act as a liaison between members, providers, and pharmacies for Medicare grievance resolution
o Provide clear and empathetic communication throughout the grievance process
- Compliance:
o Adhere to all CMS (Centers for Medicare & Medicaid Services) guidelines and company policies
o Maintain confidentiality of sensitive member information
- Documentation:
o Accurately document all interactions and resolutions in the client system
o Prepare reports as required for compliance and auditing purposes
- Collaboration:
o Work closely with other departments to investigate and resolve grievances
o Pro...
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