Medicare Grievances Coordinator

Job Summary

Tracking and managing member grievances, appeals, and IRE requests, the full-time remote Medicare Grievances Coordinator will ensure efficient resolution according to regulatory timeframes and compose professional correspondence for members.

Key responsibilities

• Investigate and respond to member complaints and grievances, and provider appeals in writing
• Utilize internal and external contacts to facilitate the grievance process effectively
• Organize tasks to comply with regulatory requirements and deadlines

Required qualifications

• Associate degree or equivalent professional work experience
• 1 year of experience in a health care environment
• Preferred background in medical claims and/or customer service
• Familiarity with ICD-10, HCPCS, and CPT4 coding and medical terminology
• Experience with Medicare and SNP preferred