Grievance & Appeals Specialist I (Remote AZ)

Centene Corp.; Tempe (AZ); Presencial; USD 27.000 - 45.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K plan

Stock purchase plans

Paid time off

Descripción de la vacante

Centene Corp. in Tempe, AZ is seeking a Grievance & Appeals Coordinator I to analyze and resolve verbal and written claims and appeals from members and providers, with in-office work at 1850 W. Rio Salado Pkwy, Ste 211.

This role requires Arizona residency and involves handling mail and document-heavy tasks. The position offers $19.43–$32.98 per hour, full-time hours, and a comprehensive benefits package, including health insurance and 401K options, with potential for growth in a mission-driven

Formación

• High school diploma or equivalent; associate’s degree preferred.
• 2+ years grievance or appeals, claims, related managed care experience, or relevant experience.
• Ability to reside in Arizona and work full-time in Tempe office.

Responsabilidades

• 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.

Conocimientos

Grievance handling

Data entry

Documentation

Communication

Educación

High School Diploma or equivalent

Associate’s degree preferred

Descripción del empleo

Centene Corp. in Tempe, AZ is seeking a Grievance & Appeals Coordinator I to analyze and resolve verbal and written claims and appeals from members and providers, with in-office work at 1850 W. Rio Salado Pkwy, Ste 211.

This role requires Arizona residency and involves handling mail and document-heavy tasks. The position offers $19.43–$32.98 per hour, full-time hours, and a comprehensive benefits package, including health insurance and 401K options, with potential for growth in a mission-driven