Complaint and Appeals Coordinator

Job Summary

A company is looking for a Coordinator, Complaint & Appeals - Work From Home.

Key Responsibilities

• Manage and resolve complex appeal scenarios, coordinating responses from multiple business units
• Research and resolve incoming electronic appeals, identifying trends and rerouting inappropriate work items
• Act as a subject matter expert, providing training and support to newer staff and coordinating internal efforts to resolve complaints and appeals

Required Qualifications

• 1 year of experience in reading or researching benefit language in SPDs or COCs
• Demonstrated ability to handle multiple assignments competently and efficiently
• Experience documenting workflows and reengineering efforts
• High School Diploma
• 1 year of experience in research and analysis of claim processing is preferred