Grievances and Appeals Coordinator
Job Summary
Coordinating the work of Member Services Representatives, the full-time remote Grievances and Appeals Coordinator will focus on intake for Part C and D Pre-Service Appeals, ensuring member inquiries are addressed and services are appropriately provided.
Key responsibilities
- Ensure member inquiries are resolved and referred to the correct service providers
- Administer policies for verifying member identity and entitlement to services
- Maintain accurate membership databases and suggest improvements based on member feedback
Required qualifications
- 0-3 years of related experience in Grievances and Appeals
- Prior experience with Intake for Part C and D Pre-Service Appeals is highly desired
- High school diploma or equivalent experience required
- Comprehensive knowledge of grievance and appeals processes
- Advanced Microsoft Office skills; familiarity with IKA, MHK, or QNXT preferred
Complete Job Description
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