Grievance & Appeals Coordinator I

Centene Corporation

Grievance and appeals coordinator resolving healthcare claims, authorization appeals, and member complaints for Centene. Managing appeals documentation, committee support, HEDIS tasks, and pay-for-performance data.

Posted 9/2/2026full-timeRemote • Kentucky • 🇺🇸 United StatesJuniorMid-Level💰 $19 - $33 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing and resolving grievances and appeals, with a strong focus on data management and compliance within managed care environments. Proficient in preparing documentation and supporting performance programs through effective organization and communication.

Highest-signal resume keywords

Grievance ResolutionClaims ManagementData EntryHEDIS ProductionManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ResearchData AnalysisDocument ManagementResponse Letter PreparationGrievance Tracking

Soft Skills

CommunicationOrganizational SkillsProblem-Solving

Industry Keywords

Managed CarePay-for-Performance ProgramsMember ComplaintsProvider AppealsGrievance and Appeals Committee

About the role

Key responsibilities & impact

Analyze and resolve verbal and written claims and authorization appeals from providers
Pursue resolution of formal grievances from members
Gather, analyze and report member and provider complaints, grievances and appeals
Prepare response letters for complaints, grievances and appeals
Maintain files on individual appeals and grievances
May coordinate the Grievance and Appeals Committee
Support pay-for-performance programs through data entry, tracking, organizing and researching information
Assist with HEDIS production functions, including data entry, provider-office calls and claims research
Manage large volumes of documents, including copying, faxing and scanning incoming mail
Perform other duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

High school diploma or equivalent
2+ years grievance or appeals, claims, related managed care experience, or relevant experience
Associate’s degree preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation