Remote Appeals & Grievances Specialist I

Medimpact; San Diego (CA); On-site; USD 25,000 - 38,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Wellness Programs

PTO & Holidays

Incentive Compensation

401K with match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact seeks an Appeals & Grievances Coordinator I to handle intake, processing, and timely resolution of appeals and grievances. You will use MedAccess, MedResponse, FileNet, and RightFax to retrieve and enter data, while maintaining privacy and adherence to regulations.

The role requires strong customer service skills, ability to multitask, and willingness to work weekend rotation. Experience with MS Office and health plan procedures is preferred.

Qualifications

• GED/HS Diploma required with 1+ year experience or equivalent
• Certified Pharmacy Technician license required; CPT certification preferred
• Proficiency in MS Office; Word and Excel experience needed

Responsibilities

• Evaluate and process Appeals and Grievances per established instructions.
• Perform outreach activities (calls/faxes) to obtain information.
• Ensure timely finalization of Appeals and Grievances per laws and policies.
• Cross-train across appeal and grievance tasks for coverage.
• Support weekend on-call rotation and maintain confidentiality.

Skills

Oral Communication

Written Communication

Teamwork

Reasoning Ability

Mathematical Skills

Education

GED/HS Diploma

Certified Pharmacy Technician License

Tools

MS Office Suite

Microsoft Word

Microsoft Excel

Job description

MedImpact seeks an Appeals & Grievances Coordinator I to handle intake, processing, and timely resolution of appeals and grievances. You will use MedAccess, MedResponse, FileNet, and RightFax to retrieve and enter data, while maintaining privacy and adherence to regulations.

The role requires strong customer service skills, ability to multitask, and willingness to work weekend rotation. Experience with MS Office and health plan procedures is preferred.