Appeal & Grievance Intake Coordinator

Appeal & Grievance Intake Coordinator

We are seeking an Appeal & Grievance Intake Coordinator to support the intake, processing, and coordination of member appeals and grievances in a fast-paced healthcare environment.

Key Responsibilities:

• Process and manage inbound/outbound appeals and grievance correspondence.
• Maintain case files, tracking logs, and ensure regulatory compliance.
• Coordinate with members, providers, Medical Directors, and internal departments.
• Research, document, and update case information across multiple systems.
• Meet productivity and quality standards while maintaining HIPAA compliance.

Required Qualifications:

• High school diploma or equivalent.
• Experience in healthcare appeals, grievances, claims, or medical administration preferred.
• Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint) and Adobe Acrobat.
• Strong communication, analytical, organizational, and customer service skills.
• Ability to manage multiple priorities, work independently, and maintain confidentiality.

Required Experience:

• Knowledge of Medicare/CMS guidelines, HIPAA, and healthcare appeals & grievance processes.
• Experience with case management or healthcare documentation systems is a plus.