Appeals and Grievances Coordinator

A company is looking for a Coordinator, Appeals & Grievances.

Key Responsibilities

Review and process case requests ensuring compliance with regulatory and health plan guidelines

Manage workload effectively to meet service level agreements using CarePro and other internal systems

Maintain accurate documentation and tracking to support reporting, compliance, and audits

Required Qualifications

High school diploma or GED is required

Minimum of 3 years' experience in an Appeals and Grievances role or similar administrative role

Proficiency with CarePro and related health plan applications is preferred

Familiarity with healthcare processes and regulatory guidelines is necessary

Experience with Windows, Excel, and related computer applications is required