Appeals & Grievances Clinical Coordinator
Remote - NYremotemid$42K – $62K
Posted today · via Workday
About this role
The Appeals and Grievances Clinical Coordinator is responsible for supporting the clinical team to ensure timely and accurate processing of cases. The clinical coordinator properly sets up case files for clinical review as needed and conducts general appeal research and filing including but not limited to organizational determination research, requesting member medical records, organizing documentation, preparing written summaries, scheduling the case, processing the review of the case, documentation of the appeal resolution and sending complete case files to external review organization as required by regulatory guidelines. The appeals and grievances may be related to all lines of business (Medicaid, Medicare, Commercial, etc.).…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
We compare your skills against the role requirements.
2
Level fit
This role is mid-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
Score yourself on this role.
Free · no card · written explanation included
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