Grievance & Appeals Coordinator I

Centene

Base: $19.43 - $32.98 ph; bonus/equity: not specif...
Hybrid
Manage large volumes of documents
Resolve verbal and written appeals
Prepare response letters for complaints
Centene is seeking a Grievance & Appeals Coordinator I to manage and resolve claims and member grievances within their Medical Management/Health Services team. The role involves analyzing documents, preparing response letters, and maintaining appeal files, with a preference for candidates possessing relevant experience in managed care

Job Summary

  • This role involves analyzing and resolving verbal and written claims and authorization appeals from providers while pursuing resolution of formal grievances from members.
  • The position requires managing large volumes of documents including copying, faxing, and scanning incoming mail alongside preparing response letters for member and provider complaints.
  • Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, and paid time off.

Matching Summary

Match Score: 75

Centene is seeking a Grievance & Appeals Coordinator I to manage and resolve claims and member grievances within their Medical Management/Health Services team. The role involves analyzing documents, preparing response letters, and maintaining appeal files, with a preference for candidates possessing relevant experience in managed care.

Salary

Base: $19.43 - $32.98 per hour; Bonus/Equity: Not specified; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, PTO

Skills & Requirements

Must-have

  • Manage large volumes of documents
  • Resolve verbal and written appeals
  • Prepare response letters for complaints
  • Maintain files on individual appeals
  • Support pay-for-performance programs

Nice-to-have

  • Experience with HEDIS production functions
  • Strong data entry and tracking skills
  • Ability to coordinate committee meetings
  • Flexible approach to work schedules

Key Requirements

  • High school diploma or equivalent
  • Associate's degree preferred
  • 2+ years grievance or appeals experience
  • Managed care experience required

Work Rights

Not specified

Tailored Resume

Cover Letter