Senior Coordinator, Appeals Compliance

Job Summary

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

Key Responsibilities

• Oversee the investigation and resolution of appeals across multiple business units, ensuring timely and customer-focused responses
• Coach team members on compliance with Federal and State regulations while managing inventory and investigating escalated cases
• Research and translate policies into clear responses for leadership on complex cases, while identifying trends and potential risks

Required Qualifications

• At least 2+ years of experience in claims platforms, patient management, compliance analysis, or related fields
• Some knowledge of Medicare and/or Medicaid is preferred
• Experience in reading or researching benefit language
• Ability to work in a fast-paced, high-volume environment
• High School diploma or GED required