Complaint and Appeals Coordinator

Job Summary

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

Key Responsibilities

• Oversee the investigation and resolution of appeals, ensuring timely and customer-focused responses
• Coach team members on compliance with Federal and State regulations while managing inventory and escalated cases
• Research and translate policies into coherent responses for leadership on escalated cases and identify trends for improvement

Required Qualifications

• At least 2+ years in claim platforms, patient management, compliance analysis, 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