Grievance & Appeals Coordinator I.

Base pay range $22.00/hr - $22.50/hr Immediate need for a talented Grievance & Appeals Coordinator I . This is a 03+ Months Contract opportunity with long-term potential and is located in GA (Remote) . Please review the job description below and contact me ASAP if you are interested. Job ID:25-81598 Pay Range: $22 - $22.50/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities The workday is spent acknowledging and resolving member appeals within established turnaround times. Member facing team but providers may reach out to request appeals on members behalf. Appeals mainly via fax but may come through phone or email Maintain or exceed 98% compliance rate for all appeal files while meeting daily productivity benchmark of 8-10 cases per day based on the volume. This role ensures regulatory compliance by managing time-sensitive member appeals in accordance with CMS and state guidelines. It requires deep knowledge of managed care processes, strong analytical and communication skills, and the ability to coordinate across departments to resolve complex issues impacting member care and health plan operations. Key Requirements and Technology Experience Formal written communication; accuracy with data entry and tracking/ independent work. Prioritization and time management skills. Regulatory knowledge (CMS, Medicaid, NCQA). High school diploma or equivalent. At least 1+ years’ experience with Grievance & Appeals. Regulatory knowledge (CMS, Medicaid, NCQA). Previous grievance and appeals or UM prior authorization experience, regulatory knowledge, critical thinking/problem solving with independent work, organizational skills, adaptability, and professionalism. This is a production environment. Interpersonal skills. Technology proficiency. Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. Job Details Seniority level: Not Applicable Employment type: Contract Job function: Health Care Provider Industries: Hospitals and Health Care #J-18808-Ljbffr