Appeal and grievance intake coordinator

Are you a highly organized healthcare administrative professional with a solid background in managed care operations? We are seeking a dedicated Appeal & Grievance Intake Coordinator to join our Government Solutions team. In this business-critical role, you will serve as the initial point of contact for the triage, setup, and tracking of Medicare Part C and Part D member cases.

This fast-paced, administrative position is perfect for an independent thinker who balances strict procedural data entry with a strong customer service mindset. You will collaborate closely with cross-functional compliance, legal, and clinical teams to ensure all documentation satisfies precise state and federal regulatory frameworks. If you have a sharp eye for sorting data and want to expand your career within a major health insurance landscape, we invite you to apply today!

salary: $17 - $17.99 per hour
shift: First
work hours: 8 AM - 5 PM
education: Bachelors

Responsibilities

Position Summary: Execute the administrative triage lifecycle-including the intake, classification, folder configuration, and team assignment-of Medicare Part C and Part D grievances and appeals. This office-based role supports regulatory compliance by carefully monitoring workflow tracking logs against strict timeliness and quality standards.

Key Responsibilities:

• Receive, sort, prioritize, and distribute incoming case mail, faxes, and inter-office correspondence.
• Classify files in compliance with the CMS Managed Care and Prescription Drug Benefit Manuals.
• Build individual electronic case folders and assign incoming claims or requests to designated case staff.
• Maintain and continuously update data records, workflow tracking logs, and statistical compliance reports.
• Communicate directly with enrolled members and medical providers to collect missing case data or formal clarifications.

Skills

• Multi-tasking
• Answering Phones
• Order Fulfillment

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.