Appeals and Grievances Coordinator

Job Summary

A company is looking for a Coordinator Appeals & Grievances.

Key Responsibilities

• Research and investigate member and provider appeals and grievances
• Facilitate and manage panel meetings, ensuring effective communication and documentation
• Maintain accurate records of appeals and grievances while ensuring compliance with policies and procedures

Required Qualifications

• High School diploma or GED required
• Minimum of two years' work experience in a Managed Care environment
• 1 to 3 years' experience in a grievance/appeals environment required
• Proven experience as a facilitator or moderator
• Familiarity with the healthcare industry and managed care principles