Healthcare Appeals Coordinator
Job Summary
Detail-oriented and experienced, the full-time remote Appeals Coordinator II will manage and resolve appeals, grievances, and provider complaints while ensuring compliance with client, state, and regulatory requirements.
Key Responsibilities
- Prepare and distribute case files for External Reviews and State Fair Hearings
- Research, investigate, and resolve provider appeals, grievances, and complaints
- Collaborate with leadership and clinical staff to resolve complex cases
Required Qualifications
- Associate's Degree or equivalent combination of education and relevant experience
- Minimum of 3 years of experience in the healthcare industry
- Strong analytical and critical thinking abilities
- Excellent organization and time management skills
- Ability to manage multiple priorities and meet strict deadlines
Complete Job Description
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