Ohio Licensed Appeals Coordinator

Job Summary

A company is looking for a Temporary Coordinator remote - Appeals & Grievances.

Key Responsibilities

• Process and resolve appeals, grievances, and disputes from members and providers
• Document appeal requests and grievances, ensuring compliance with CMS guidelines
• Conduct investigations and prepare case files for review and submission to relevant entities

Required Qualifications

• Bachelor's degree or equivalent combination of education and experience
• Three years of customer service or appeals and grievance experience, preferably in managed care
• Legal or regulatory background is highly desired
• Familiarity with claims processing and coordination of benefits
• Ability to interpret and apply Federal law and regulatory requirements