Grievance & Appeals Coordinator I

Centene Corp.; Kansas; Híbrido; USD 27.000 - 45.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K plan

Stock purchase plan

Tuition reimbursement

Paid time off + holidays

Remote/hybrid work flexibility

Descripción de la vacante

Centene Corp. in Kansas is seeking a detail‑oriented Grievances and Appeals Specialist to gather, analyze and report member and provider complaints, grievances and appeals, and to prepare response letters.

The role supports HEDIS production functions and data entry, handles large volumes of documents, and coordinates committee activities, with a standard Mon-Fri schedule and remote flexibility within Kansas.

Formación

• Gather, analyze and report complaints, grievances and appeals.
• Prepare response letters for member and provider appeals.
• Maintain files on individual appeals and grievances.

Responsabilidades

• Coordinate Grievance and Appeals Committee if needed.
• Support pay-for-performance programs: data entry, tracking and research.
• Assist with HEDIS production functions: data entry, provider calls, claims research.
• Manage large volumes of documents: copying, faxing and scanning incoming mail.

Conocimientos

Grievance handling

Appeals processing

Data entry

Documentation

Educación

High school diploma

Associate’s degree preferred

Herramientas

HEDIS

Descripción del empleo

Position Purpose:

• 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.

Key Details:

Remote role must reside in Kansas. The work schedule is Monday – Friday, 8am – 5pm with some flexibility possible once fully trained.

Education/Experience:

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

Pay Range: $19.43 - $32.98 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act