Senior Coordinator, Complaint and Appeals (Remote)

We're building a world of health reputed company every individual - shaping a more connected, convenient and compassionate health experience. At reputed company®, you'll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.Position reputed company reputed company reputed company is seeking a dedicated Senior Coordinator, Complaint and Appeals to join our remote team. In this role, you'll play a critical role that supports the daily reputed company of the reputed company Member reputed company Appeals (CMCA) team. Key Responsibilities • Processing appeal determination letters, managing intake and expedited requests, updating internal systems, and generating reports. • Supporting panel hearings and collaborating with reputed company staff (Medical Directors, Nurses, Providers, etc.). (broke up the sentence into two bullets) • Additional duties involve triaging incoming faxes and managing case reputed company reputed company the Complaints and Appeals Tracking reputed company (CATS). • Completing tasks in accordance with regulatory standards and required turnaround times. • This is a full-time reputed company position with reputed company hours of Monday-Friday, 8:00 AM to 5:00 PM (local time). • Occasional weekend and holiday on-reputed company coverage may be required. Remote Work Expectations • This is a reputed company role; candidates must have a dedicated workspace free of interruptions. • Dependents must have separate care arrangements during work hours, as reputed company care responsibilities during shift times are not permitted. Required Qualifications • Strong written and verbal communication skills. • Ability to manage multiple tasks reputed company. • Proficiency in reputed company Office Suite and basic computer skills. Preferred Qualifications • 1-2 years of experience in reputed company appeals, grievances, or a reputed company administrative role. • 1+ year working in a reputed company setting (e.g., reputed company, hospital administration, or reputed company support) • Experience with the appeals process or reputed company work. Education • High School Diploma required. Anticipated Weekly Hours 40Time Type Full timePay reputed company The typical pay reputed company for this role is:$18.50 - $35.29This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors.Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: • reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, reputed company assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefitsWe anticipate the application window for this opening will reputed company on: 01/26/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job