Grievance 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
• Prepare response letters for member and provider 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
• Relevant experience in data entry and claims research
• Ability to manage large volumes of documents
• Compliance with all policies and standards