Kansas Licensed Grievance Coordinator

Job Summary

Analyzing and resolving verbal and written claims and authorization appeals, the full-time Kansas Licensed Grievance Coordinator will manage member and provider complaints, maintain files on appeals and grievances, and support pay-for-performance programs in a remote work environment.

Key responsibilities

• Gather, analyze, and report on member and provider complaints, grievances, and appeals
• Prepare response letters for complaints and maintain organized files on individual appeals
• Assist with HEDIS production functions, including 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 managed care
• Knowledge of healthcare regulations and compliance standards