Senior Appeals Operations Coordinator

Job Summary

A company is looking for a Senior Coordinator Complaint Appeals Operations, fully remote.

Key Responsibilities

• Manage resolution of complex appeal scenarios across multiple business units
• Research and resolve incoming electronic appeals, ensuring proper routing and identifying trends
• Act as a subject matter expert, providing training and coordinating efforts for claims research and regulatory compliance

Required Qualifications

• 1 year of experience in reading or researching benefit language in SPDs or COCs
• Experience documenting workflows and reengineering efforts
• 1 year of experience in research and analysis of claim processing (preferred)
• High School Diploma
• Strong leadership skills