Senior Appeals Coordinator

Job Summary

Managing complex appeal scenarios remotely, the full-time Senior Appeals Coordinator will resolve incoming electronic appeals, coordinate responses from various business units, and develop into a subject matter expert by providing training and support.

Key responsibilities

• Research and resolve incoming electronic appeals as a single point of contact
• Assemble data for denial determinations and act as a subject matter expert on workflows and appeals processes
• Coordinate efforts across departments to resolve claims research and triage complaint/appeal issues

Required qualifications

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