Complaint and Appeals Coordinator

Job Summary

A company is looking for a Coordinator, Complaint and Appeals - Work From Home.

Key Responsibilities

• Manage resolution of 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, products, and benefits
• Experience in patient management, product compliance, and regulatory analysis
• Experience in special investigations, provider relations, customer service, or audit
• High School diploma or equivalent required