Complaint Appeals, Senior Coordinator - Fully Remote

Position Summary

Provide support to the Supervisors by coaching, mentoring and training new staff. Oversight over inventory. Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals. Identify trends and emerging issues and report and recommend solutions. Independently coaches others on appeals ensuring compliance with Federal and/or State regulations.

Requirements

• 2-4 years of experience in a Customer Service role.
• 2-4 years of Medicare and/or Medicaid knowledge.
• At least 2-4 years of experience that includes but is not limited to clinical and claim platforms, benefits and services.
• Compliance and regulatory knowledge; provider relations and customer service.
• Experience in reading or researching benefit language.
• Ability to work in fast paced environment.
• Excellent verbal and written communication skills.
• Excellent organizational skills to handle high inventory which aids in meeting or exceeding metrics.
• Solution driven and can handle complex issues with accuracy.
• Availability to work alternating weekends for oversight of analysts on alternate schedule.

Qualifications

• High School Diploma or GED required or 2-4 years of equivalent work experience.
• Audit experience.
• Critical thinking experience.
• Ability to work complex issues.
• Team Player.
• Exhibit How We Work Behaviors: Solution Driven.

Pay

The Typical Pay Range For This Role Is $18.50 - $38.82. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.