Grievance & Appeals Coordinator I - 210056

Grievance & Appeals Coordinator I - 210056

BCforward is currently seeking a highly motivated Grievance & Appeals Coordinator I in Work Location: Remote (Central Time Zone)

Job Title

Grievance & Appeals Coordinator I
Hourly Pay Rate: $27.00 (W2)

• Work Type: Contract (Extend only)
• Duration: 6 months
• Target Start Date: February 2, 2026
• Schedule: Monday-Friday, 8:00 AM - 5:00 PM CST
• Work Location: Remote (Central Time Zone)
• Candidate Location: Open to all U.S. states (must work CST hours)

Position Overview

The Grievance & Appeals Coordinator I is responsible for analyzing, screening, and resolving verbal and written member and provider grievances, complaints, and appeals. This role supports timely and accurate case intake, documentation, and routing to ensure compliance with regulatory and organizational standards.

This is a fast-paced, remote role that requires strong attention to detail, organization, and effective communication.

Key Responsibilities

• Gather, analyze, and document verbal and written grievances, complaints, and appeals from members and providers
• Screen and intake grievances and appeals received via Omni, mail, email, and fax
• Create and distribute cases in the system for appropriate resolution
• Prepare written response letters for member and provider grievances and appeals
• Maintain accurate and organized files for individual cases
• Coordinate with internal teams, including Member Relationship Specialists
• Support Grievance & Appeals Committee activities as needed
• Assist with pay-for-performance programs, including data entry, tracking, organizing, and research
• Support HEDIS-related activities such as data entry, provider outreach, and claims research
• Manage large volumes of documentation including scanning, faxing, and copying
• Participate in daily team communications to ensure workflow efficiency
• May provide occasional weekend coverage; overtime is not mandatory

Typical Day in the Role

• Review and screen incoming grievances and appeals from multiple sources
• Accurately enter and route cases for timely handling
• Communicate with internal teams via daily team chats
• Maintain productivity and quality in a high-volume, remote work environment
• Work independently while collaborating closely with team members

Education & Experience

Required:

• Associate's Degree in Healthcare Administration (or equivalent experience)
• 2-3 years of experience in grievances, appeals, claims, or managed care operations
• Strong written, verbal, and problem-solving skills

Preferred:

• Bachelor's Degree

Required Skills (Top Must-Haves)

Strong attention to detail and accuracy

Excellent organizational and time-management skills

Effective communication and collaboration abilities

Additional Qualifications

• Ability to manage high volumes of work in a fast-paced environment
• Self-starter with the ability to work independently in a remote setting
• Comfortable asking questions and seeking clarification when needed
• Strong basic computer skills; typing and system navigation proficiency

Interested candidates please send resume in Word format Please reference job code 248699 when responding to this ad.

---