Senior Coordinator, Appeals Management

Job Summary

To support a growing team, the full-time Senior Coordinator, Appeals Management will oversee the investigation and resolution of appeals scenarios, ensuring timely and customer-focused responses while collaborating with multiple business units in a remote environment.

Key responsibilities

• Manage the oversight of appeals investigations, ensuring compliance with federal and state regulations
• Research and translate policies into clear responses for escalated cases, serving as a point of contact for inquiries from leadership and regulators
• Identify trends and emerging issues, reporting findings and recommending solutions to improve processes

Required qualifications

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