Remote CTM Appeals & Grievances Coordinator

Alignment Health; United States; Remote; USD 48,000 - 73,000; Full time

Job summary

Alignment Health is seeking a CTM Coordinator, Appeals & Grievances, to manage day-to-day intake, investigation tracking, and resolution of CTMs for CMS. This remote role requires weekend availability and cross-department collaboration to address member issues promptly.

Responsibilities include monitoring CTM, gathering information, documenting actions, and drafting CMS-facing responses, with emphasis on timely, compliant resolutions and ongoing reporting.

Qualifications

• At least 1 year in Member Services or similar experience; 2+ years with Medicare Advantage.
• Preferred: Direct CTM experience with a Medicare Advantage plan.
• High school diploma or GED required; AA preferred.

Responsibilities

• Monitor CTM portal daily for new cases.
• Acknowledge receipt of CTM grievances and appeals.
• Gather information from members, providers, and departments per CMS guidelines.
• Draft CMS-facing written responses within required turnaround times.
• Prepare case histories for committee meetings and reporting.

Skills

Communication skills

Attention to detail

Typing speed 40 wpm

Time management

Leadership

Cross-functional collaboration

Bilingual English/Spanish

Education

High school diploma or GED

Associate degree

Tools

CMS CTM

CRM systems

Job description

Alignment Health is seeking a CTM Coordinator, Appeals & Grievances, to manage day-to-day intake, investigation tracking, and resolution of CTMs for CMS. This remote role requires weekend availability and cross-department collaboration to address member issues promptly.

Responsibilities include monitoring CTM, gathering information, documenting actions, and drafting CMS-facing responses, with emphasis on timely, compliant resolutions and ongoing reporting.