Washington State Grievance Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator I.

Key Responsibilities

• Manage and resolve member and provider complaints, grievances, and appeals while ensuring compliance with regulations
• Conduct thorough investigations and document all actions taken to resolve grievances and appeals
• Prepare accurate case documentation and maintain complete files for all grievances and appeals

Required Qualifications

• High School Diploma or equivalent combination of education and experience
• Minimum of one year operational experience in a managed health care environment
• Experience with Medicaid and Medicare programs
• Prior experience in grievance/appeal resolution
• Knowledge of medical terminology is strongly preferred