Senior Appeals Coordinator

Job Summary

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

Key Responsibilities

• Conducts team reviews and escalates complex issues to management
• Ensures compliance with regulatory requirements and addresses identified issues
• Facilitates reviews of decisions and oversees the drafting of appeal decision letters

Required Qualifications

• 3-5 years of experience in a Customer Service role preferred
• Experience in reading or researching benefit language
• Knowledge of Medicare and/or Medicaid
• At least 5 years of relevant experience in claims, compliance, or customer service
• High school diploma or equivalent required