Grievance & Appeals Coordinator I

Centene Corporation•Tempe, AZ

7d•$19 - $33•Onsite

About The Position

Analyze and resolve verbal and written claims and authorization appeals from providers, and pursue resolution of formal grievances from members. Candidates must reside in Arizona and be able to work full-time in the office at the Tempe, Arizona location. Mailroom experience is preferred. The role supports pay-for-performance programs and HEDIS production, manages high volumes of documents, and performs other assigned duties while complying with company policies and standards.

Requirements

High school diploma or equivalent.
At least 2 years of grievance or appeals, claims, related managed care, or relevant experience.
Must reside in Arizona.
Must be able to work full-time in the office at the Tempe, Arizona location.

Nice To Haves

Associate’s degree.
Mailroom experience.

Responsibilities

Gather, analyze, and report verbal and written member and provider complaints, grievances, and appeals.
Prepare response letters for member and provider complaints, grievances, and appeals.
Maintain files on individual appeals and grievances.
May coordinate the Grievance and Appeals Committee.
Support pay-for-performance programs through data entry, tracking, organizing, and researching information.
Assist with HEDIS production functions, including data entry, calls to provider offices, and claims research.
Manage large volumes of documents, including copying, faxing, and scanning incoming mail.
Perform other duties as assigned.
Comply with all policies and standards.