Appeals and Grievances Coordinator

A company is looking for a Coordinator Appeals & Grievances.

Key Responsibilities

Research and investigate member and provider appeals and grievances

Facilitate and manage panel meetings, ensuring effective communication and documentation

Maintain accurate records of appeals and grievances while ensuring compliance with policies and procedures

Required Qualifications

High School diploma or GED required

Minimum of two years' work experience in a Managed Care environment

1 to 3 years' experience in a grievance / appeals environment required

Proven experience as a facilitator or moderator

Familiarity with the healthcare industry and managed care principles