Remote Appeals & Grievances Coordinator

P32HS Point32Health Services Inc; Canton (MA); Hybrid; USD 44,000 - 66,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement plans

Paid time off

Life and disability insurance

Tuition program

Well-being benefits

Job summary

Point32Health is seeking an Appeals and Grievance Coordinator to support the A&G Analyst by handling mail, organizing cases, and ensuring timely processing in accordance with state and federal regulations.

The role requires 1-2 years in health care customer service and 1-2 years in appeals and grievances, with strong organizational and communication skills. Hybrid work options and comprehensive benefits are provided.

Qualifications

• Associate’s Degree or equivalent experience in health care or related field.
• 1-2 years of member services/customer service experience in health care.
• 1-2 years’ Appeals and Grievance experience in assigning and handling appeals and grievances.
• Excellent organizational skills and interpersonal/communication skills.
• Proficient in Excel and Word; knowledge of medical terminology.

Responsibilities

• Assign new verbal and written appeals and grievances to Appeals and Grievances Analyst.
• Support A&G Analyst in timely completion of Appeals and Grievances.
• Adheres to all regulatory, internal and compliance timeliness expectations.
• Responsible for distribution of incoming mail as well as department manual mail processing.
• Other duties and projects as assigned.

Skills

Organizational skills

Interpersonal communication

Multitasking

Problem solving

Attention to detail

Effective written/spoken communication

Education

Associate’s Degree or equivalent

Tools

Excel

Word

Windows applications

Job description

Point32Health is seeking an Appeals and Grievance Coordinator to support the A&G Analyst by handling mail, organizing cases, and ensuring timely processing in accordance with state and federal regulations.

The role requires 1-2 years in health care customer service and 1-2 years in appeals and grievances, with strong organizational and communication skills. Hybrid work options and comprehensive benefits are provided.