Senior Coordinator Appeals Operations

Job Summary

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

Key Responsibilities

• Manage and resolve complex appeal scenarios, coordinating responses from multiple business units
• Research and analyze incoming electronic appeals, identifying trends and rerouting inappropriate work items
• Act as a subject matter expert on workflows, denial determinations, and regulatory compliance

Required Qualifications

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