Grievance and Appeals Coordinator

Title: G&A Coordinator (Medicare / Medicaid Appeals & Grievances) Location: Fully Remote (AZ Residents Only) Duration: 6-Month Contract (High Likelihood of Extension/Conversion) Overview: We are seeking experienced G&A Coordinators to support a high-volume Grievances & Appeals team due to increased workload. This role focuses on member and provider appeals, grievances, and claim disputes, requiring strong analytical and writing skills. This position serves as a key advocate for health plan members, ensuring timely and accurate resolution of complex cases while maintaining compliance with regulatory requirements. Responsibilities: Review, research, and resolve member and provider appeals, grievances, and disputes Draft clear, compliant resolution letters Interpret and apply CMS, AHCCCS, and internal guidelines Handle both standard appeals and grievance intake cases Maintain productivity in a high-volume environment Collaborate with internal teams to ensure accurate case resolution Serve as a point of contact for member concerns and escalations Requirements (Must-Have): 3–4+ years of Grievance & Appeals experience in a healthcare environment Strong experience with: Appeals review, research, and resolution Drafting resolution letters Experience with: Medicaid (AHCCCS strongly preferred) Medicare Member-facing or provider-facing experience Strong understanding of CMS regulations Ability to work in a high-volume, metrics-driven environment Nice to Have: Experience with Arizona Medicaid (AHCCCS) Prior health plan / payer-side experience Metrics: Intake: 4–5 cases/hour Closures: 5–6 cases/hour Why Join: High-impact role supporting healthcare access and advocacy Strong potential for extension or conversion Collaborative team of 13+ coordinators