Grievance & Appeals Coordinator I

Centene Management Company • Tempe, AZ

15h • Onsite

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is an in-office role, Monday - Friday, 8AM to 5PM. The role will manage large volumes of documents including copying, faxing and scanning incoming mail. The purpose of this position is to analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

Requirements

• High school diploma or equivalent.
• 2+ years grievance or appeals, claims, related managed care experience, or relevant experience.

Nice To Haves

• Associate’s degree preferred.

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 the pay-for-performance programs, including data entry, tracking, organizing, and researching information
• Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
• Manage large volumes of documents including copying, faxing and scanning incoming mail
• Performs other duties as assigned.
• Complies with all policies and standards.

Benefits

• competitive pay
• health insurance
• 401K
• stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• a flexible approach to work with remote, hybrid, field or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees