Provider Appeals Coordinator​/CPC​/CCS- Remote in Virginia or Florida!

Provider Appeals Coordinator/CPC/CCS – Remote (Virginia or Florida)

Full‑time, permanent position (40 hours per week). Standard hours 8 am – 5 pm EST, Monday to Friday. Remote location:
Virginia or Florida.

Sentara Health Plans is hiring an Appeal Coordinator. The role involves investigating and documenting member appeals and grievances in compliance with state law and plan regulations, working closely with Medical Directors and Appeals Manager.

• Investigate and document member appeals and grievances in compliance with state law, applicable rules and regulations, and provider and group agreements.
• Collaborate with the Plan’s Medical Directors to support clinical appeals/grievances and with the Appeals Manager for non‑clinical appeals/grievances.

• High School Graduate or equivalent.
• Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) from AHIMA.
• 3+ years of Managed Care experience; previous provider appeals experience preferred.

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy reimbursement up to $10,000
• Paid Time Off, Sick Leave, Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long‑Term, Short‑Term Disability, Critical Illness plans
• Life Insurance
• 401(k)/403(b) with Employer Match
• Tuition Assistance – $5,250/year and discounted opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and CEUs
• Pet Insurance
• Legal Resources Plan
• Annual discretionary bonus if eligibility criteria met

Sentara Health is an equal opportunity employer and supports a tobacco‑free environment.

Apply at using the keyword search JR‑87716.

Mid‑Senior level

Full‑time