Complaint and Appeals Coordinator

Job Summary

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

Key Responsibilities

• Manage resolution of complaint and appeal scenarios across multiple products and business units
• Ensure timely and 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 customer service
• Experience in product compliance and regulatory analysis
• Experience in special investigations and provider relations
• High School diploma or equivalent required