Appeals Coordinator

The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies. The Coordinator is expected to analyze the customers’ concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions.

• Analytical mindset - having the ability to examine a matter, the facts, contextual information and make an informed decision or implement a reasonable, rationale solution.
• Excellent written and verbal communication skills. Must be proficient in proofreading, spelling, grammar, punctuation, and math.
• Ability to analyze, interpret, apply reason and logic, conduct research; structure a clear and thorough response.

• Ability to apply policies and procedures to arrive at accurate conclusions.
• Ability to work in a fast‑paced environment with tight deadlines and high quality standards.
• Problem solving aptitude.
• Accuracy and strong attention to detail.
• Ability to prioritize responsibilities and effectively manage time.
• Ability to work effectively with management and part of a team to meet targets.
• High regard for protecting confidentiality of member, employee, corporate and performance information.
• Previous customer service or concierge experience.
• Strong PC application and system skills - having the ability to navigate multiple computer systems and databases.

• Background in writing and/or research.

Bachelor’s Degree in English, Communication, Health Care Administration,