Appeals and Grievances Coordinator

A company is looking for a Coordinator, Appeals & Grievances. Key Responsibilities Receive and process inbound appeals requests through various communication channels Collect and organize information to expedite the appeal process and generate acknowledgment letters Research and refer delegated appeals to clinical teams while meeting productivity and quality standards Required Qualifications and Experience Minimum of 2 years of experience in processing appeals preferred At least 3 years of experience in a health plan, managed care organization, or third-party administrator preferred Understanding of the appeals process and utilization management Working knowledge of regulatory and accreditation requirements Technical capability for high-speed internet and direct connection to the home router

Apr 14, 2025 - 18:22

A company is looking for a Coordinator, Appeals & Grievances. Key Responsibilities Receive and process inbound appeals requests through various communication channels Collect and organize information to expedite the appeal process and generate acknowledgment letters Research and refer delegated appeals to clinical teams while meeting productivity and quality standards Required Qualifications and Experience Minimum of 2 years of experience in processing appeals preferred At least 3 years of experience in a health plan, managed care organization, or third-party administrator preferred Understanding of the appeals process and utilization management Working knowledge of regulatory and accreditation requirements Technical capability for high-speed internet and direct connection to the home router