Centene Corporation

Grievance and Appeals Coordinator I

Centene Corporation

  • Date Posted

    Today

    New!
  • Remote Work Level

    100% Remote

  • Location

    Remote in IN

  • Job Schedule

    Full-Time

  • Salary

    $19 - $32 Hourly

  • Benefits

    Health Insurance Retirement Savings Education Assistance Paid Holidays Paid Time Off

  • Categories

    AdministrativeAdminData EntryInsurance

  • Job Type

    Employee

  • Career Level

    Experienced

  • Travel Required

    No specification

  • Education Level

    We're sorry, the employer did not include education information for this job.

About the Role

Grievance & Appeals Coordinator I

locations

Remote-IN

time type

Full time

job requisition id

1620866

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Position Purpose:
Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

  • Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
  • Prepare response letters for member and provider complaints, grievances and appeals
  • Maintain files on individual appeals and grievances
  • May coordinate the Grievance and Appeals Committee
  • Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
  • Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
  • Manage large volumes of documents including copying, faxing and scanning incoming mail
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience:
High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance or appeals, claims, related managed care experience, or relevant experience.

Pay Range: $19.04 - $32.35 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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