Grievance & Appeals Coordinator I at Centene

**Who this is for** This mid-level, on-site position is for a detail-oriented individual with experience in healthcare administration, specifically handling mem

Work type: onsite

Location: Tempe - 1850 W. Rio Salado Pkwy, Ste 211 (US Script)(10312)

Salary: $19 – $33/hr

Type: Full-time

Summary

**Who this is for** This mid-level, on-site position is for a detail-oriented individual with experience in healthcare administration, specifically handling member and provider grievances and appeals. You will be a key point of contact in resolving complex issues and ensuring smooth operational workflows. **Key highlights** As a Grievance & Appeals Coordinator, you will analyze and resolve a high volume of claims and authorization appeals, prepare response letters, and maintain accurate records. This role is crucial for maintaining member and provider satisfaction and ensuring compliance. **You might be a good fit if you...** - Have 2+ years of experience in grievance/appeals, claims, or related managed care roles. - Possess strong analytical and organizational skills. - Are comfortable managing large volumes of documents and performing data entry. - Have experience in a healthcare environment and can effectively communicate with providers and members.

Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Location: In office role, Monday - Friday, 8AM to 5PM.Will manage large volumes of documents including copying, faxing and scanning incoming mail.Position Purpose:
Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

• Gather, analyze and report verbal and written member and provider complaints, grievances and appeals


• Prepare response letters for member and provider complaints, grievances and appeals


• Maintain files on individual appeals and grievances


• May coordinate the Grievance and Appeals Committee


• Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information


• Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.


• Manage large volumes of documents including copying, faxing and scanning incoming mail


• Performs other duties as assigned.


• Complies with all policies and standards.

Pay Range: $19.43 - $32.98 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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