Grievance & Appeals Coordinator I

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $19 - $32 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Analyze and resolve verbal and written claims and authorization appeals from providers • Pursue resolution of formal grievances from members • Gather, analyze and report member and provider complaints, grievances and appeals • Prepare response letters for complaints, grievances and appeals • Maintain files on individual appeals and grievances • May coordinate the Grievance and Appeals Committee • Support pay-for-performance programs through data entry, tracking, organizing and researching information • Assist with HEDIS production functions, including data entry, provider-office calls and claims research • Manage large volumes of documents, including copying, faxing and scanning incoming mail • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• High school diploma or equivalent • 2+ years grievance or appeals, claims, related managed care experience, or relevant experience • Associate’s degree preferred

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation