Strategic Appeals & Grievances Coordinator

Point32Health, Inc.; Canton (MA); Hybrid; USD 29,000 - 44,000; Full time

Job summary

The Appeals and Grievance (A&G) Coordinator at Point32Health is responsible for assisting with operational aspects of the A&G assignment process in line with state and federal rules. Responsibilities include processing mail, coordinating with vendors, tracking cases, and supporting the A&G Analyst.

The role requires 1–2 years of health care or member services experience and an Associate’s Degree or equivalent.

Qualifications

• Associate’s Degree or equivalent experience in health care or related field.
• 1–2 years of member services or health care experience.
• 1–2 years’ Appeals and Grievance experience preferred.

Responsibilities

• Assign new appeals to the Appeals and Grievances Analyst.
• Support Analyst in timely completion of Appeals and Grievances.
• Adhere to regulatory, internal and compliance timeliness expectations.
• Distribute incoming mail and department manual mail processing.
• Other duties and projects as assigned.

Skills

Organizational skills

Interpersonal communication

Attention to detail

Medical terminology

Education

Associate’s Degree or equivalent in health care

Tools

Excel

Word

Windows

Job description

The Appeals and Grievance (A&G) Coordinator at Point32Health is responsible for assisting with operational aspects of the A&G assignment process in line with state and federal rules. Responsibilities include processing mail, coordinating with vendors, tracking cases, and supporting the A&G Analyst.

The role requires 1–2 years of health care or member services experience and an Associate’s Degree or equivalent.