Grievance and Appeals Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator I to analyze and resolve claims and authorization appeals.

Key Responsibilities

• Gather, analyze, and report on member and provider complaints, grievances, and appeals
• Prepare response letters for complaints, grievances, and appeals from members and providers
• 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
• Must reside in Arizona
• Claims and provider dispute experience preferred
• Experience with data entry and managing large volumes of documents