Appeals & Grievances Coordinator I

VERDEGARD ADMINISTRATORS LLC

San Diego, CA, United States
Base: $17.92 - $22.85 - $27.78; bonus/equity: not ...
Fully remote
Process appeals and grievances per established standards
Ensure compliance with state and federal regulations
Utilize medaccess, medresponse, filenet, and rightfax
The Appeals and Grievances Coordinator I serves as a key member of the team responsible for managing all aspects of the appeals and grievances process including intake, processing, notification, and compliance

Job Summary

  • The Appeals and Grievances Coordinator I serves as a key member of the team responsible for managing all aspects of the appeals and grievances process including intake, processing, notification, and compliance.
  • MedImpact is seeking innovative professionals who thrive on opportunity and teamwork to deliver leading edge pharmaceutical solutions that improve the value of health care.
  • This position offers comprehensive benefits including medical, dental, vision, wellness programs, paid time off, incentive compensation, and a 401K with company match.

Matching Summary

The Appeals and Grievances Coordinator I serves as a key member of the team responsible for managing all aspects of the appeals and grievances process including intake, processing, notification, and compliance.

Salary

Base: $17.92 - $22.85 - $27.78; Bonus/Equity: Not specified; Benefits: Comprehensive pay and benefits reviewed at offer stage

Skills & Requirements

Must-have

  • Process appeals and grievances per established standards
  • Ensure compliance with state and federal regulations
  • Utilize MedAccess, MedResponse, FileNet, and RightFax
  • Perform outreach via outbound calls and faxes
  • Meet required turnaround times for case resolution
  • Adapt to rotating weekend on-call schedules

Nice-to-have

  • Strong reasoning skills for evaluating requests
  • Ability to multitask and cross-train effectively
  • Excellent customer service and interpersonal communication
  • Experience in a team-oriented high-performance environment
  • Flexibility with shift changes and business needs

Key Requirements

  • GED/HS Diploma and 1+ year experience
  • Certified Pharmacy Technician or state licensure required
  • Proficiency in Microsoft Word and Excel
  • Must be eligible to work in the US (No sponsorship)

Work Rights

Not specified

Tailored Resume

Cover Letter