Medicaid Appeals Coordinator

Job Overview

Job Description

Medicaid Appeals Coordinator needs 2+ years of grievance or appeals experience

Medicaid Appeals Coordinator requires:

College degree (minimum of Associates) or equivalent work experience

2+ years of grievance or appeals experience

Ability to effectively relate to a wide range of individuals from a diverse population.

Excellent customer service skills

Previous experience demonstrating problem-solving skills.

Strong organizational and communication skills, oral and written.

Working knowledge of Eligibility rules and processes and a willingness to gain an understanding of other operational processes

Ability to work independently.

Medicaid Appeals Coordinator duties:

Demonstrate strong understanding of Medicaid, CHIP and the Affordable Care Act

Provide detail documentation regarding the outcome and action of the review.

Send appropriate communication to client identifying outcome of review.

Maintain a copy of all outgoing letters in the designated folder

Work with consumer and other organizations to resolve issues timely, accurately and professionally.

Conduct daily monitoring and tracking of all incoming work to ensure SLAs are met. .