Grievance and Appeals Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator I.

Key Responsibilities

• Analyze and resolve verbal and written claims and authorization appeals from providers and members
• Prepare response letters for complaints, grievances, and appeals
• Maintain files on individual appeals and grievances and support pay-for-performance programs

Required Qualifications

• High school diploma or equivalent; Associate's degree preferred
• 2+ years of experience in grievance or appeals, claims, or related managed care
• Experience with data entry and document management
• Familiarity with HEDIS production functions is a plus
• New Hampshire residence is highly preferred