Complaint and Appeals Coordinator

Job Summary

A company is looking for a Complaint and Appeals Coordinator - Fully Remote.

Key Responsibilities

• Manage and resolve complaint/appeal scenarios across multiple products
• Ensure timely, customer-focused responses to complaints and appeals
• Identify trends and emerging issues, reporting and recommending solutions

Required Qualifications

• 1 year of experience with HMO and Traditional claim platforms, patient management, and compliance analysis
• High School diploma or equivalent
• Experience in customer service or audit roles
• Medicare experience is preferred
• Claims experience and familiarity with benefit language in SPDs or COCs is a plus