Complaints and Appeals Coordinator

Job Summary

A company is looking for a Complaints and Appeals Coordinator, fully remote.

Key Responsibilities

• Oversee the investigation and resolution of appeals across multiple business units while ensuring timely, customer-focused responses
• Coach team members on compliance with Federal and State regulations and manage control and trend inventory
• Research and translate policies into clear responses for leadership on escalated cases, identifying risks and recommending solutions

Required Qualifications

• At least 2+ years of experience in claims, patient management, compliance, or related fields
• 2+ years of Medicare experience
• Proficient in computer use, including Excel and Electronic Health Records (EHR) systems
• High School Diploma or GED