CTM Coordinator, Appeals & Grievances

Job Summary

Managing the day-to-day intake and resolution of grievances and appeals, the full-time CTM Coordinator, Appeals & Grievances will work remotely, including weekends, to ensure timely processing and documentation of cases in accordance with CMS guidelines.

Key responsibilities

• Monitor the CTM portal for new cases and acknowledge receipt of grievances and appeals
• Conduct comprehensive investigations and gather information to determine appropriate resolutions
• Document all actions taken and prepare reports for compliance and regulatory audits

Required qualifications

• At least one year of Member Services or similar experience
• 2+ years of experience working with Medicare Advantage healthcare plans
• High school diploma or GED required; Associate degree preferred
• Ability to type at least 40 words per minute and use a 10-key keypad by touch
• Strong oral and written communication skills, including drafting CMS-facing correspondence