Grievance & Appeals Coordinator

Immediate need for a  talented Grievance & Appeals Coordinator. This is a 12 Months Contract opportunity with long-term potential and is US (Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job Diva ID: 26-00137
 
Pay Range: $22.00 - $23.00/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:

• Process and resolve member appeals and grievances in accordance with internal policies, timelines, and regulatory requirements
• Review case documentation for completeness, accuracy, and compliance
• Maintain clear and professional communication with internal stakeholders regarding case status and resolution
• Draft clear, accurate, and compliant written correspondence related to appeals and grievances
• Collaborate with team members on complex cases and contribute to case discussions
• Identify trends, issues, or improvement opportunities within case workflows
• Support quality initiatives aimed at meeting or exceeding performance benchmarks
• Maintain detailed and accurate records within internal systems

Key Requirements and Technology Experience: 

• Key Skills; 2-3 years of experience in appeals and grievances, healthcare administration, insurance operations, or another regulated environment
• Strong knowledge of federal and state healthcare regulations (Medicare/Medicaid preferred)
• Demonstrated letter-writing or formal correspondence experience
• Strong attention to detail and accuracy
• Effective written and verbal communication skills
• Ability to manage multiple cases and deadlines in a fast-paced environment
• Knowledge of healthcare regulations, including Medicare and Medicaid guidelines
• Experience handling complex or compliance-related cases
• Strong conflict resolution and customer service skills
• Exposure to cross-functional coordination or project support 
• Consistently meet or exceed quality benchmarks (approximately 97% accuracy)
• Resolve cases within required turnaround times
• Demonstrate strong collaboration and proactive communication
• Contribute to customer satisfaction through effective case resolution
• High School Diploma or GED 

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.

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