Appeals Coordinator

Lucet

. Process and document all aspects of appeal cases, including receipt date and time, investigation of appeal substance, and related records, comments, or information .

Posted 10/7/2026full-timeRemote • United StatesJunior💰 $22 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare appeals and claims processing, ensuring compliance with regulatory standards and organizational policies. Proficient in documentation and communication, with a strong ability to manage multiple priorities in a fast-paced environment.

Highest-signal resume keywords

Healthcare Appeals ExperienceClaims ProcessingRegulatory ComplianceMicrosoft Office ProficiencyProblem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Healthcare AppealsClaims ManagementUtilization ManagementDocumentation SkillsRegulatory Knowledge

Soft Skills

Organizational SkillsAttention to DetailFlexibilityCollaborationProfessional Demeanor

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookAppeals Documentation System

Industry Keywords

NCQAURACDOLCMSHealthcare Regulations

About the role

Key responsibilities & impact

Process and document all aspects of appeal cases, including receipt date and time, investigation of appeal substance, and related records, comments, or information
Understand and apply standards established by NCQA, URAC, DOL, CMS, and federal and state laws
Understand member and provider rights and responsibilities related to claims and appeals
Assist Appeals Specialists with day-to-day Appeals Department operations
Research and document appeals and claims in compliance with regulatory requirements, business rules, and department guidelines
Support accurate determinations and issuance of compliant notices
Monitor appeal workflows and turnaround times
Ensure complete and accurate case documentation and timely case resolution
Collaborate with Appeals Specialists, customer service, and reimbursement teams
Communicate with members, providers, health plans, and internal stakeholders, escalating issues as needed
Maintain regulatory, organizational policy, ethical, confidentiality, and compliance standards
Meet productivity, accuracy, and turnaround-time goals

Requirements

What you’ll need

Associates degree and 1+ year of relevant healthcare experience
Equivalent combination of education and relevant healthcare appeals, claims, utilization management, or health plan experience may be considered in lieu of a degree, including high school diploma with 3+ years’ of relevant healthcare experience
1+ years of healthcare appeals, claims, utilization management or related health plan experience
Proficient in Microsoft Office (Word, Excel, Outlook, etc.) and appeals documentation system
Demonstrated knowledge of applicable federal and state regulations, accreditation standards, privacy, confidentiality, and security requirements related to healthcare information
Ability to pass background check upon hire and throughout employment, including criminal, employment, education, sanctions, prohibited parties, sex offender registry, and 10-panel drug screening
Demonstrated flexibility and adaptability to changing processes and various software programs
Ability to manage multiple priorities in a fast-paced environment
Professional demeanor and ability to work collaboratively with multiple levels of professionals and line staff
Ability to participate positively in team processes and lead team activities
Excellent problem-solving, organizational, and attention-to-detail skills
Work from a single designated home office; travel between multiple residences or remote work locations is not supported
High-speed internet service with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds, installed before starting
Quiet workspace with minimal background noise for calls

Benefits

Comp & perks

Comprehensive health benefit options: Medical, dental, and vision coverage
401(k) with competitive employer match
Company-paid life and disability insurance
Paid parental leave and wellbeing incentives
Generous paid time off, including volunteer time
Flexible spending accounts for healthcare and dependent care
Professional development opportunities and tuition reimbursement
Remote work flexibility (role-dependent)
Opportunity for meaningful growth, both personally and professionally
Company-provided equipment