Senior Appeals Coordinator

Job Summary

A company is looking for a Senior Coordinator, Complaint & Appeals - Remote.

Key Responsibilities

• Manage resolution of complex appeal scenarios and coordinate responses from multiple business units
• Research and resolve incoming electronic appeals, identifying trends and rerouting inappropriate work items
• Assemble data for denial determinations and coordinate efforts across departments to resolve claims and complaints

Required Qualifications

• 1-2 years of Medicare Part C Appeals experience
• Experience in reading or researching benefit language in SPDs or COCs
• Experience in research and analysis of claim processing
• Demonstrated ability to handle multiple assignments accurately and efficiently
• High School Diploma