Grievance & Appeals Coordinator

Job Description:

Position Overview:
We are seeking an organized, detail-oriented Grievance & Appeals Coordinator to process appeals within contractual timelines, review and resolve member and provider complaints, and ensure compliance with all regulatory and contractual requirements. While this role is primarily remote, it requires one in-person trip per month to our Indianapolis office for a team meeting.

The ideal candidate will have outstanding written and verbal communication skills and the ability to self-manage their time effectively in a fast-paced environment. Experience in the transportation industry is a plus.

Key Responsibilities:

• Accurately enter and track appeals in the system within required timeframes.
• Analyze and resolve verbal and written claims and authorization appeals from providers.
• Investigate and resolve formal grievances from members.
• Prepare clear, professional response letters for members and providers.
• Maintain well-organized, complete files for each case.
• Support pay-for-performance programs through data entry, tracking, research, and organization.
• Assist with research activities, including data entry, provider calls, and claims research.
• Manage large volumes of documentation, including scanning, faxing, copying, and processing incoming mail.

  Why Join Us?

• Mostly remote role with a predictable weekday schedule.
• Competitive pay range of $19–$21/hour, based on experience.
• Monthly team connection in Indianapolis.
• Opportunity to make a meaningful impact on member and provider satisfaction.