Grievance and Appeals Coordinator

Job Summary

Analyzing and resolving claims and authorization appeals, the full-time Grievance and Appeals Coordinator will manage verbal and written complaints from providers and members while working remotely from Arizona.

Key responsibilities

• Gather, analyze, and report on member and provider complaints, grievances, and appeals
• Prepare response letters for grievances and maintain files on individual cases
• Support pay-for-performance programs through data entry and claims research

Required qualifications

• High school diploma or equivalent; Associate's degree preferred
• 2+ years of experience in grievance or appeals, claims, or relevant managed care experience
• Knowledge of HEDIS production functions and related data entry tasks