Grievance and Appeals Coordinator

Job Summary

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

Key Responsibilities

• Analyze and resolve claims and authorization appeals from providers and formal grievances from members
• Prepare response letters and maintain files on individual appeals and grievances
• Support pay-for-performance programs and assist with HEDIS production functions

Required Qualifications

• High school diploma or equivalent; associate's degree preferred
• 2+ years of experience in grievance or appeals, claims, or related managed care