Senior Coordinator, Complaint & Appeals
Core
Review and manage patient complaints, appeals, and grievances to ensure fair, compliant resolution and improve the overall patient experience.
Role type
Senior Coordinator, Compliance & Patient Relations
Builds
Patient complaint resolution workflows and appeal decision letters
Domain
Healthcare / Insurance / Regulatory Compliance
Deliverable
dashboards & analysis
Required skills
Case analysis, regulatory interpretation, KPI analysis, audit execution, process improvement, team mentoring
Preferred skills
Healthcare, insurance, or compliance experience
Responsibilities
Review and manage patient complaints, appeals, and grievances; Conduct in-depth case analysis to identify errors or compliance gaps; Coordinate and draft appeal decision letters; Perform audits and monitor compliance with federal and state regulations; Analyze KPIs to improve team performance; Support patient billing inquiries; Train and mentor team members on best practices
