Grievance & Appeals Coordinator I

Centene Corporation

. Analyze and resolve verbal and written claims and authorization appeals from providers .

Posted 9/17/2026full-timeRemote • California • 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 strong capabilities in data entry, document management, and compliance with policies and standards. Proficient in gathering and reporting on member and provider complaints to support pay-for-performance programs.

Highest-signal resume keywords

Grievance And Appeals ManagementClaims ResearchData Entry And TrackingDocument ManagementHEDIS Production Functions

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievance AnalysisAppeals ResolutionClaims ManagementData ReportingDocument Organization

Soft Skills

CommunicationProblem-SolvingAttention To Detail

Industry Keywords

Managed CarePay-For-Performance ProgramsMember ComplaintsProvider ComplaintsCalifornia Residency

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 verbal and written member and provider complaints, grievances, and appeals
Prepare response letters for member and provider complaints, grievances, and appeals
Maintain files on individual appeals and grievances
Coordinate the Grievance and Appeals Committee as needed
Support pay-for-performance programs through data entry, tracking, organizing, and researching information
Assist with HEDIS production functions, including data entry, calls to provider offices, and claims research
Manage documents, including copying, faxing, and scanning incoming mail
Perform other duties as assigned

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Candidates must reside near Woodland Hills, California
High school diploma or equivalent
2+ years of grievance or appeals, claims, related managed care experience, or relevant experience
Ability to gather, analyze, and report member and provider complaints, grievances, and appeals
Associate’s degree preferred
Ability to manage large volumes of documents
Ability to comply with all policies and standards

Benefits

Comp & perks

Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off
Holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity