Complaint and Appeals Coordinator

Job Summary

A company is looking for a Complaint and Appeals Coordinator - Fully Remote.

Key Responsibilities

• Manage and resolve complaint and appeal scenarios across multiple business units
• Ensure timely and customer-focused responses to complaints and appeals
• Identify trends and emerging issues, reporting and recommending solutions

Required Qualifications

• 1 year of experience with HMO and Traditional claim platforms, patient management, and customer service
• High School diploma or equivalent
• Experience in compliance and regulatory analysis
• Experience in special investigations or provider relations is preferred
• Medicare and claims experience are advantageous