Arizona Licensed Grievance Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator II.

Key Responsibilities

• Analyze and resolve claims and authorization grievances/appeals from providers and members
• Review and process grievances and appeals in compliance with regulations and policies
• Collaborate with internal experts and serve as a liaison between members, providers, and regulatory agencies

Required Qualifications

• Bachelor's degree in a related field or equivalent experience
• 2+ years of claims, contracting, or related experience in a managed care environment
• Knowledge of federal, state, and organizational regulations related to grievances and appeals
• Experience preparing cases for medical review
• Ability to lead Appeals and Grievance Committee activities