Sr Appeal and Grievance Coordinator - Prefer Candidate lives in IL

Are you a highly organized and detail-oriented individual with a passion for helping others? Do you have experience in managing appeals and grievances in the healthcare industry? Aetna is seeking a Senior Appeal and Grievance Coordinator to join our team in Illinois. In this role, you will play a critical role in ensuring that our members receive the highest quality of care and service. As a preferred candidate, you will bring a deep understanding of appeals and grievances processes, along with strong communication and problem-solving skills. If you are driven, compassionate, and dedicated to making a positive impact in the lives of others, we encourage you to apply for this exciting opportunity. Manage and oversee the appeals and grievances process for Aetna's healthcare members in Illinois. Utilize strong organizational skills to track and monitor appeals and grievances, ensuring timely resolution. Communicate effectively with members, providers, and internal teams to gather necessary information and provide updates on the status of appeals and grievances. Utilize knowledge of healthcare industry regulations and policies to ensure compliance with relevant laws and guidelines. Analyze data and trends to identify areas for improvement in the appeals and grievances process. Act as a liaison between members and providers, advocating for fair and equitable resolutions. Collaborate with internal teams to develop and implement strategies for improving member satisfaction and reducing appeals and grievances. Utilize problem-solving skills to resolve complex appeals and grievances. Maintain accurate and detailed records of appeals and grievances, ensuring confidentiality and security of sensitive information. Train and mentor junior team members on appeals and grievances processes and procedures. Stay up-to-date on industry developments and changes in appeals and grievances regulations. Act with empathy and compassion towards members, understanding the impact that appeals and grievances can have on their healthcare experience. Work independently and efficiently in a fast-paced environment, managing multiple tasks and deadlines effectively. Adhere to company policies and procedures, including ethical and professional standards. Represent Aetna in a positive and professional manner at all times. Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply tot his job