Senior Appeals Coordinator

A company is looking for a Senior Coordinator Complaint Appeals Operations, fully remote. Key Responsibilities Manage and resolve complex appeal scenarios requiring coordination across multiple business units Act as a subject matter expert by providing training, coaching, and responding to complex issues Research and analyze claims processing logic, benefit denials, and regulatory compliance Required Qualifications 1-2 years of Medicare Part C appeals experience 1 year of experience in reading or researching benefit language in SPDs or COCs 1 year of experience in research and analysis of claim processing High School Diploma Experience documenting workflows and reengineering efforts

Mar 25, 2025 - 05:29

A company is looking for a Senior Coordinator Complaint Appeals Operations, fully remote. Key Responsibilities Manage and resolve complex appeal scenarios requiring coordination across multiple business units Act as a subject matter expert by providing training, coaching, and responding to complex issues Research and analyze claims processing logic, benefit denials, and regulatory compliance Required Qualifications 1-2 years of Medicare Part C appeals experience 1 year of experience in reading or researching benefit language in SPDs or COCs 1 year of experience in research and analysis of claim processing High School Diploma Experience documenting workflows and reengineering efforts