Remote Grievance & Appeals Specialist II

Centene Management Company LLC; Florida; Híbrido; USD 32.000 - 55.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/work schedule

Descripción de la vacante

Centene Corp. is seeking a remote Grievance & Appeals Coordinator II to analyze and resolve grievances and appeals from members and providers.

The candidate will review cases, prepare for medical review when needed, and act as a subject matter expert on grievances and appeals. The role requires a Bachelor’s degree (or equivalent) with 2+ years in a managed care environment, and strong written and verbal communication skills.

Formación

• Bachelor’s degree in related field or equivalent experience.
• 2+ years of claims, contracting, or related experience in a managed care environment.
• Strong written and oral communication skills.

Responsabilidades

• Analyze and resolve grievances and appeals from members and providers.
• Review and process grievances and appeals within federal, state and organizational regulations and procedures.
• Lead Appeals and Grievance Committee.
• Collaborate with internal teams and our Health Plan partners.

Conocimientos

Grievance investigation

Communication skills

Collaboration

Leadership

Educación

Bachelor’s degree in related field

Descripción del empleo

Centene Corp. is seeking a remote Grievance & Appeals Coordinator II to analyze and resolve grievances and appeals from members and providers.

The candidate will review cases, prepare for medical review when needed, and act as a subject matter expert on grievances and appeals. The role requires a Bachelor’s degree (or equivalent) with 2+ years in a managed care environment, and strong written and verbal communication skills.