New Mexico Appeals Coordinator

A company is looking for an Appeals and Grievance Coordinator.

Key Responsibilities

Coordinate daily activities of the Appeals & Grievance Department, providing mentorship and oversight

Investigate and resolve customer complaints and appeals / grievances, making decisions in disputed cases

Maintain compliance with regulatory standards and represent the organization in audits and meetings with regulatory bodies

Required Qualifications

High School Diploma or GED

Five years of customer service experience required

Three years of experience in a healthcare or insurance setting, with one year in complaint, grievance, or appeal processing

Bachelor's degree preferred in a healthcare-related field

Preferred experience in claims processing and patient financial services in an HMO / MCO / MSO or health insurance environment