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This is a 40-hour-per-week Member Appeals & Grievances Coordinator contract position in Charlestown, MA, running from November 2, 2026 through January 30, 2027. This position is paying $21.60/hour. The position is with a health insurance/healthcare organization and focuses on the accurate intake, documentation, tracking, and distribution of member appeals and grievances while supporting regulatory compliance, reporting, and internal auditing.
Key Responsibilities:
- Identify, intake, document, and distribute member appeals and grievances accurately and within required deadlines.
- Maintain accurate information in the Appeals & Grievances system of record.
- Respond professionally to members, providers, and internal departments regarding case status and procedures.
- Maintain organized, secure, and compliant records.
- Identify trends, procedural concerns, or potential issues and escalate them to management.
- Assist with audits, monitoring, and daily, weekly, or monthly reporting.
- Analyze data and identify trends to support management reporting.
- Help maintain efficient workflows designed to minimize manual errors and improve consistency.
- Participate in or lead training for specialists, coordinators, and new staff.
- Maintain current training materials and support additional Appeals & Grievances functions as needed.
Candidate Qualifications:
- Bachelor’s degree in healthcare administration or a related field, or an equivalent combination of education, training, and experience.
- Proficiency with Microsoft Office applications and healthcare management systems.
- Strong attention to detail, organization, problem-solving, and data-entry skills.
- Ability to analyze information, identify trends, and recognize procedural irregularities.
- Excellent written, verbal, interpersonal, and customer-service skills.
- Ability to multitask and work independently in a fast-paced environment while collaborating across departments.
- Preferred: 2+ years of healthcare experience specifically involving appeals and grievances.
- Preferred: Health insurance experience involving Commercial, Medicaid, and Medicare plans and their applicable rules and regulations.
- Preferred systems experience: JIVA, Facets, Express Scripts, Inc., and HPMS.
- Experience with data entry, reporting, and trend analysis is preferred.
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