Grievance Coordinator Resume

[First Name] [Last Name]

Contact Address: [street]

[Country] [City] [State/Province] [Zip Code]

Contact Number: (012)-345-6789

Email Address: [[email protected]]

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Career Objective:

To work as a grievance coordinator with “Star Insurance Company” where I can investigate and resolve complaints of customers utilizing research skills and regulatory knowledge.

Summary of Skills:

  • Experience in investigating and resolving complaints related to insurance
  • Excellent communication, negotiation and convincing skills
  • Skilled at studying data and identifying mistakes and loopholes within
  • Superior research and investigative skills that help perform root cause analysis
  • Excellent analytical, computer, and problem-solving skills
  • A thorough professional with high regards to corporate ethics and mannerisms

Work Experience:

Grievance Coordinator
Fair Medical Billing, Inc., Peoria, AZ
April 2014 – Present

  • Review and find solutions for customers’ complaints
  • Collected medical history of insurers and consult medical expert on panel for clarification
  • Gather facts, analyze the root cause of complaints, and draft report on findings
  • Maintain files of all insurance policy holders and verify if the policy is still current
  • Coordinate between grievance and appeals committee and settle matter outside the court
  • Negotiate with customers and health-care providers and try to solve problems amicably

Grievance Coordinator
Fine Insurance Company, Peoria, AZ
August 2012 – March 2014

  • Called meetings of policy holders and health care providers and attended their grievances
  • Processed and resolved filed compliance according to the rules set by the company
  • Saved millions of dollars for the company by researching and exposing false medical claims
  • Prepared case files on policy holders and submitted for management review
  • Sent acknowledgement letters to customers against complaint received and scheduled meetings nor negotiations
  • Handled inbound calls and resolved complaints over the phone itself for minor problems

Education:

  • Bachelor’s Degree in Health Care
    ABC College, Peoria, AZ
    2011

Reference:

On request.