Grievance and Appeals Coordinator

A company is looking for a Grievance & Appeals Coordinator.

Key Responsibilities

Analyze and resolve claims and authorization appeals from providers and formal grievances from members

Prepare response letters for member and provider complaints, grievances, and appeals

Maintain files on individual appeals and grievances

Required Qualifications

High school diploma or equivalent; Associate's degree preferred

2+ years of experience in grievance or appeals, claims, or related managed care

Experience with data entry and document management

Familiarity with HEDIS production functions is a plus

Ability to work flexible shifts between 7am - 5pm PST, Monday to Friday