Member Appeals Coordinator

Job Summary

Managing the intake and distribution of member appeals and grievances, the full-time remote Member Appeals Coordinator will perform administrative functions, ensure data accuracy, and maintain organized record-keeping processes while collaborating with various departments.

Key responsibilities:

• Accurately identify and enter appeals and grievances into the system, ensuring timely distribution to specialists
• Support data integrity for trend analysis and reporting while identifying trends for management review
• Assist in audits and create reports for the A&G Management team, including training for new staff as needed

Required qualifications:

• Bachelor's degree in Health Care Administration or a related field, or equivalent experience
• Proficiency in Microsoft Office Applications and experience with healthcare management systems
• Minimum of 2 years of experience in a healthcare setting related to Appeals and Grievances
• Experience with data entry, trend analysis, and reporting in a health insurance context
• Familiarity with rules and regulations governing health insurance (Commercial, Medicaid, and Medicare)