Grievance & Appeals Coordinator | Remote | Contract

Grievance & Appeals Coordinator | Remote | Contract

Walker Healthforce is seeking a Grievance & Appeals Coordinator with experience in customer service, analytical decision-making, and written communication to process member appeals, grievances, complaints, and inquiries. This is a Contract opportunity.

Start Date: ASAP Location:
Remote Hours/Schedule: Monday-Friday, 40 hours Worker Type: W2

Core Requirements:

• Previous customer service or concierge experience, with strong customer communication and problem-solving abilities.

• Strong analytical and critical thinking skills to evaluate complex information and make accurate, informed decisions.

• Excellent written and verbal communication skills, including proofreading, spelling, grammar, punctuation, and math.

• Ability to research, interpret, and apply policies and procedures to develop clear, thorough written responses.

• Strong organizational skills, attention to detail, and ability to manage competing priorities and strict deadlines.

• Proficiency in navigating multiple computer applications, systems, and databases.

• Ability to work independently and collaboratively while maintaining confidentiality and meeting quality standards.

• Associate Degree, Relevant Certification, or Bachelor's Degree in Related Field.

We Consider It A Bonus If You Also Have:

• Previous grievance and appeals experience, particularly involving Medicare.

• Background in professional writing, research, or policy interpretation.

• Experience managing caseloads involving claims, appeals, billing, coding, or case management.

• Healthcare customer service or call center experience.

• Bachelor's degree or coursework in English, writing, healthcare administration, history, law, or a related field.

Job Responsibilities:

• Process appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies.

• Analyze customer concerns, research relevant information, and determine appropriate case resolutions.

• Coordinate and facilitate conferences with customers and authorized representatives to gather and communicate information.

• Maintain accurate and comprehensive documentation of case activities, findings, and resolutions.

• Prepare clear, professional written correspondence explaining decisions and outcomes.

• Ensure case processing and responses comply with applicable regulatory, accreditation, accuracy, and timeliness standards.

• Apply current policies, procedures, and product knowledge to resolve customer concerns accurately.

What We Offer:

• Competitive compensation package

• Weekly pay via Direct Deposit

• Medical, Dental & Vision available

• 401k options

Why Work With Walker?

• Access to our top ranked team of recruiting and placement specialists

• Continuous, one-on-one support from a dedicated engagement manager

• Professional resume development and interview preparation

Contact our Recruiting Team today to experience the Walker Healthforce difference!

About Us:

Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we're custom not commodity and we've been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!

We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment.