Appeals and Grievances Coordinator

Job Summary

A company is looking for a Coordinator, Appeals & Grievances.

Key Responsibilities

• Receive and process inbound appeals requests through various communication channels
• Collect and organize information to expedite the appeal process and generate acknowledgment letters
• Research and refer delegated appeals to clinical teams while meeting productivity and quality standards

Required Qualifications and Experience

• Minimum of 2 years of experience in processing appeals preferred
• At least 3 years of experience in a health plan, managed care organization, or third-party administrator preferred
• Understanding of the appeals process and utilization management
• Working knowledge of regulatory and accreditation requirements
• Technical capability for high-speed internet and direct connection to the home router