Massachusetts Licensed Appeals Coordinator

Job Summary

To support member intake and data management, the remote Member Appeals & Grievances Coordinator will handle the identification, data entry, and distribution of member appeals and grievances while maintaining secure records and assisting with audits and reporting.

Key responsibilities

• Support the intake, identification, and distribution of member appeals and grievances
• Maintain secure records and respond to member/provider inquiries
• Assist with audits, reporting, trend analysis, and training

Required qualifications

• Bachelor's degree in Healthcare Administration or a related field, or equivalent education and experience
• Experience with Microsoft Office and healthcare management systems
• Two or more years in healthcare appeals and grievances preferred
• Knowledge of Commercial, Medicaid, and Medicare
• CPC certification is preferred