Appeals and Grievances Coordinator

Job Summary

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

Key Responsibilities

• Review and process appeal requests in accordance with regulatory requirements and health plan guidelines
• Conduct research and analysis of case documentation and claims data to ensure completeness
• Maintain accurate documentation and tracking in internal systems to support appeal workflows and compliance

Required Qualifications

• A high school diploma or GED
• 3 years of experience in an Intake Coordinator role or relevant experience in health plans or managed care organizations
• 2 years of experience processing appeals (preferred)
• Proficient in using computer and Windows PC applications
• Ability to adapt to fluctuating situations and perform detailed work accurately