Grievance & Appeals Coordinator I

Centene Management Company LLC; Tempe (AZ); On-site; USD 27,000 - 45,000; Full time

Job summary

Centene Management Company LLC in Tempe, AZ is seeking a claims, grievances and appeals specialist to analyze and resolve verbal and written appeals from providers and respond to member grievances.

The role requires residency in Arizona, a high school diploma (associate's preferred) and 2+ years in grievance or appeals, claims within managed care. The pay range is $19.43 to $32.98 per hour, with benefits and flexible schedules.

Qualifications

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

Responsibilities

• Analyze and resolve verbal and written claims and authorization appeals from providers.
• Prepare response letters for member and provider complaints, grievances and appeals.
• Maintain files on individual appeals and grievances.
• Coordinate the Grievance and Appeals Committee as needed.
• Support pay-for-performance programs, including data entry and tracking.
• Assist with HEDIS production functions including data entry and calls to provider offices.
• Manage large volumes of documents including copying, faxing and scanning incoming mail.
• Ensure compliance with policies and standards.

Skills

Grievance handling

Appeals processing

Data entry

Documentation

Education

High school diploma or equivalent

Associate's degree preferred

Job description

Position Purpose:

Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

Key Details:

Candidates must reside in Arizona and be able to work full-time, in office at our Tempe, AZ location. Mailroom experience is preferred.

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.

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.

Benefits:

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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.

Thanks for your interest in Centene and its subsidiary companies.

We’re so glad that you’ve decided to fill out an application and take the next step to find your purpose.

Also, we’re here to help support you on your candidate journey.

Should you need an accommodation, please email [e-mail].

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.