Senior Appeals Coordinator

Job Summary

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

Key Responsibilities

• Manage and resolve complex appeal scenarios, coordinating responses from multiple business units
• Research and analyze claim processing logic and benefit denials, acting as a subject matter expert
• Identify trends in complaints and appeals, providing insights and support for internal quality reviews and audits

Required Qualifications

• 1-2 years of experience in Medicare Part C Appeals
• Experience in reading and researching benefit language in SPDs or COCs
• Ability to handle multiple assignments accurately and efficiently
• Experience documenting workflows and reengineering efforts
• High School Diploma