Grievances and Appeals (GAD) Coordinator
Remote
Core
Coordinate a team of Member Services Representatives handling Part C and D Pre-Service Appeals intake for older adults.
Role type
Team lead / Coordinator for Member Services Appeals
Builds
Member service workflows and appeal intake processes
Domain
Healthcare / Medicare Advantage
Required skills
Grievance and appeals knowledge, Member identity verification, Database management, Policy administration, Team leadership, Problem solving
Preferred skills
AI curiosity, IKA/MHK/QNXT experience, Advanced Microsoft Office
Responsibilities
Ensure member inquiries are addressed, Administer policies for verifying member identity and entitlement, Maintain membership databases, Suggest new service offerings based on feedback, Provide leadership and mentoring to subordinates
Seniority
Mid-level, hands-on IC with team leadership