Medicare Appeals Coordinator

Job Summary

Coordinating and processing member complaints for the Medicare line of business, the full-time remote Medicare Appeals Coordinator will manage the lifecycle of appeals, ensuring timely resolution and documentation while collaborating with internal and external stakeholders.

Key responsibilities

• Handle and resolve a high volume of incoming appeals while ensuring compliance with regulatory timeframes
• Document grievances accurately in tracking systems and maintain complete files with all relevant information
• Collaborate with various departments and assist with external appeal investigations and responses to regulatory agencies

Required qualifications

• High School Diploma required; Bachelor's Degree preferred
• 3-5 years of health plan experience, particularly in customer service or appeals and grievances
• Experience leading appeals and grievances for Medicare products is highly preferred
• Bilingual candidates are a plus
• Strong aptitude for technology-based solutions and excellent organizational abilities