Complaint and Appeals Coordinator

A company is looking for a Coordinator, Complaint & Appeals - Work From Home.

Key Responsibilities

Review and process appeals filed by participating providers

Assist with adherence to regulatory requirements and conduct internal audits

Draft and send appeal decision letters

Required Qualifications

1 year experience in HMO and Traditional claim platforms, patient management, and regulatory analysis

Experience in special investigations, provider relations, customer service, or audit

High School diploma or equivalent