Analyzing and resolving claims and authorization appeals, the full-time Grievance Coordinator will work remotely to handle verbal and written complaints from providers and pursue resolutions for member grievances. Key responsibilities: Gather, analyze, and report on member and provider complaints, grievances, and appeals Prepare response letters for complaints and maintain files on individual appeals and grievances Support pay-for-performance programs through data entry, tracking, and researching information 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 HEDIS production functions and claims research is a plus
Grievance Coordinator in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.