Grievance And Appeals Coordinator

Urgently hiring multiple REMOTE Grievances and Appeals coordinators (Must be based in  CA, AZ, NV, NM, or TX)

Must have:

+ Must have at least 1 year of recent grievances and appeals experience

+ Reliable internet and experience working remotely

+ Medicare Advantage plan is highly preferred

ESSENTIAL JOB RESULTS:

Investigates member grievances and appeals by gathering supporting documentation from internal departments, contracted Provider Organizations (PO), and non-contracted entities as indicated.

Communicates with the members or providers to request and gather pertinent information. Follows up as needed and documents accordingly.

Refers case to RN or management as needed.

Tracks and monitors movement of assigned cases through SCANs functional units and systems, to ensure compliance with designated timelines.

Responds to requests for information from all regulatory agencies within required time frames.

Responds to and closes cases within designated regulatory time requirements as identified by case types. Generates and sends appropriate communications.

Understands SCAN benefit structure and maintains current and additional information as it relates to Grievances and Appeals services.

Utilizes department desktop procedures, workflows, job aids and training material. Identifies barriers to work processes and brings to the attention of the supervisor/manager.

Covers week-end on-call rotation as assigned.

Maintains the members right to privacy and protects SCAN operations by keeping information confidential.

Adheres to all quality, compliance and regulatory standards to achieve HCS and SCAN outcomes.

Skills

Claims, Grievances, Appeals, Healthcare, Medical Terminology, Medicare, Managed Care

Top Skills Details

Claims,Grievances,Appeals,Healthcare,Medical Terminology,Medicare,Managed Care

Additional

Skills & Qualifications

High School Diploma, Required

2 - 3 years of experience within grievances and appeals in a healthcare, health plan, or managed care setting

Medicare Advantage plan is highly preferred

Technical - Basic technical skills :
Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) are required.

IKA, MHK, or QNXT preferred.

Experience Level

Intermediate Level

Job Type & Location

This is a Contract position based out of Phoenix, AZ.

Pay and Benefits

The pay range for this position is $24.00 - $24.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Final date to receive applications

This position is anticipated to close on Oct 2, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change.

That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services  

Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000…