Why BayCare?

At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

Summary:

• Handles and processes customer appeals and grievances in accordance with established guidelines, company policies, and legal regulations.

• Receive and document customer appeals and grievances via multiple channels (phone, email, online portals) in systems.

• Ensure accurate and timely processing of all intake information according to company and regulatory standards.

• Assign cases to the appropriate departments for review and resolution.

• Serve as the first point of contact for customers who wish to appeal decisions or file grievances, ensuring that their concerns are properly documented and addressed.

• Prepare reports on the volume and status of appeals and grievances as requested by management.

• Maintain up-to-date knowledge of all relevant laws and policies.

• Adhere to deadlines for case resolution and reporting requirements.

Minimum Qualifications:

Required Education: HS Graduate or Equivalent GED

Required Experience:

• 1 year of experience in Customer Service, Claims, Appeals, or Healthcare Administration.

• Previous experience in handling Appeals and Grievances is a plus.

• Knowledge of healthcare or insurance industry regulations is highly desirable.

Facility:

BayCare Health System, Tampa Startup-BHS

Location: BayCare System Office West

Status: Full Time, Exempt: No

Shift Hours: Varies

Shift : Days

Weekend Work: Occasional

On Call: No

How often will this team member be working remotely? Hybrid - must reside in Florida

Equal Opportunity Employer Veterans/Disabled

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