Senior Grievances & Appeals Strategist

Medasource; Phoenix (AZ); On-site; USD 45,000 - 65,000; Full time

Job summary

Medasource in Arizona seeks an experienced Grievance & Appeals Coordinator to maintain logs, review requests, and assist the Grievance & Appeals Manager in complex appeals. This role supports data reporting, dashboards, and regulatory compliance within HP policy, AHCCCS, HCG, and CMS guidelines.

You will collaborate with multiple departments, produce periodic reports, and assist with audits and on-call escalations, ensuring timely and accurate responses for members and providers.

Qualifications

• Two years of work experience in a health care related field or managing projects/initiatives.
• Three to four years of grievance and appeal work in a health care environment.
• Maintains knowledge of AHCCCS, HCG, and CMS regulations through training.

Responsibilities

• Maintains State Fair Hearing Logs and ensures regulatory requirements are met.
• Reviews State Fair Hearing requests and coordinates with Grievance & Appeals Manager.
• Prepares for higher levels of appeals and coordinates with other departments.
• Assists in producing reports, dashboards, and data validation.
• Supports on-call shifts for expedited appeals and grievances as needed.
• Collaborates with Marketing on member letters and notices.

Skills

Grievance & Appeals

Healthcare experience

Project coordination

Data reporting

Attention to detail

Education

High school diploma or GED

Job description

Medasource in Arizona seeks an experienced Grievance & Appeals Coordinator to maintain logs, review requests, and assist the Grievance & Appeals Manager in complex appeals. This role supports data reporting, dashboards, and regulatory compliance within HP policy, AHCCCS, HCG, and CMS guidelines.

You will collaborate with multiple departments, produce periodic reports, and assist with audits and on-call escalations, ensuring timely and accurate responses for members and providers.