Professional Management Enterprises
Grievance & Appeals Coordinator
Professional Management Enterprises, Indianapolis, Indiana, United States, 46260
Job Description
Job Description Description:
Position Overview: We are seeking an organized, detail-oriented
Grievance & Appeals Coordinator
to process appeals within contractual timelines, review and resolve member and provider complaints, and ensure compliance with all regulatory and contractual requirements. While this role is primarily remote, it requires
one in-person trip per month to our Indianapolis office
for a team meeting. The ideal candidate will have
outstanding written and verbal communication skills
and the ability to
self-manage their time effectively
in a fast-paced environment. Experience in the transportation industry is a plus.
Key Responsibilities: Accurately enter and track appeals in the system within required timeframes. Analyze and resolve verbal and written claims and authorization appeals from providers. Investigate and resolve formal grievances from members. Prepare clear, professional response letters for members and providers. Maintain well-organized, complete files for each case. Support pay-for-performance programs through data entry, tracking, research, and organization. Assist with research activities, including data entry, provider calls, and claims research. Manage large volumes of documentation, including scanning, faxing, copying, and processing incoming mail. Why Join Us? Mostly remote role with a predictable weekday schedule. Competitive pay range of $19–$21/hour, based on experience. Monthly team connection in Indianapolis. Opportunity to make a meaningful impact on member and provider satisfaction. Requirements:
High school diploma or equivalent required; Associate’s degree preferred. 0–2 years of related experience; transportation industry experience is a plus. Outstanding written and verbal communication skills. Strong self-management and time management abilities. Excellent attention to detail and organizational skills. Proficiency with Microsoft Office and ability to learn new systems quickly.
Job Description Description:
Position Overview: We are seeking an organized, detail-oriented
Grievance & Appeals Coordinator
to process appeals within contractual timelines, review and resolve member and provider complaints, and ensure compliance with all regulatory and contractual requirements. While this role is primarily remote, it requires
one in-person trip per month to our Indianapolis office
for a team meeting. The ideal candidate will have
outstanding written and verbal communication skills
and the ability to
self-manage their time effectively
in a fast-paced environment. Experience in the transportation industry is a plus.
Key Responsibilities: Accurately enter and track appeals in the system within required timeframes. Analyze and resolve verbal and written claims and authorization appeals from providers. Investigate and resolve formal grievances from members. Prepare clear, professional response letters for members and providers. Maintain well-organized, complete files for each case. Support pay-for-performance programs through data entry, tracking, research, and organization. Assist with research activities, including data entry, provider calls, and claims research. Manage large volumes of documentation, including scanning, faxing, copying, and processing incoming mail. Why Join Us? Mostly remote role with a predictable weekday schedule. Competitive pay range of $19–$21/hour, based on experience. Monthly team connection in Indianapolis. Opportunity to make a meaningful impact on member and provider satisfaction. Requirements:
High school diploma or equivalent required; Associate’s degree preferred. 0–2 years of related experience; transportation industry experience is a plus. Outstanding written and verbal communication skills. Strong self-management and time management abilities. Excellent attention to detail and organizational skills. Proficiency with Microsoft Office and ability to learn new systems quickly.