Temporary Coordinator remote - Appeals & Grievances - MediGold Health Plan

Job description

Employment Type: Full time Shift: Day Shift Description: This is a temporary, full‑time position with an expected duration to July 2026 Full time Monday through Friday: Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more. Position Purpose: ​ T he Appeals and Grievance Coordinator is responsible for the processing and resolution of appeals, grievances and disputes from members and providers What You Will Do: - Document all appeal requests or grievances upon receipt in the operating systems and routes cases to appropriate clinical personnel for review. - Obtain confidential medical records from providers offices utilizing secure methods. - Responsible for preparation of case files and review with clinical colleagues. - Screen all incoming grievances, appeals and provider claim dispute to ensure they are within compl...