Appeals Coordinator

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Appeals Coordinator based in United States.

This role is responsible for coordinating and managing appeal cases while ensuring decisions are handled accurately and within required timeframes. You will maintain a caseload, review medical and clinical documentation, and determine the appropriate administrative or clinical appeal pathway. The position combines case management, data entry, customer communication, documentation, and cross-functional coordination.

You will work closely with physician advisers, medical directors, case managers, supervisors, and other stakeholders to resolve complex appeal questions. The role also contributes to reporting, audits, quality improvement initiatives, and employee training. Strong organization, attention to detail, and communication skills are essential for maintaining high standards and regulatory compliance.