Grievance Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator I

Key Responsibilities:

• Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members
• Prepare response letters for member and provider complaints, grievances, and appeals
• Manage large volumes of documents including copying, faxing, and scanning incoming mail

Required Qualifications:

• High school diploma or equivalent; Associate's degree preferred
• 2+ years of grievance or appeals, claims, or related managed care experience
• Experience in coordinating Grievance and Appeals Committee is a plus
• Experience with HEDIS production functions is beneficial
• Experience in managing data entry, tracking, organizing, and researching information