Grievance & Appeals Coordinator

Job DescriptionTitle: Grievance & Appeals Coordinator Location: Detroit, MI (Fully Remote) Duration: 12+ Months Role Type: W2 Contract Engagement Pay Rate: $32-35/HR No candidates from the following: FL, AZ, NY, NJ, MO, MA, MD, CA Note: Individuals will be responsible for analyzing, researching, resolving, and responding to complaints, appeals, and grievances from members and regulatory agencies. Responses to all cases require a detailed written correspondence to the inquirer. All response letters must include specific elements to meet regulatory and accreditation guidelines. Please note that we are looking for individual who can work in a high stress, high volume, and heavily audited area. We anticipate this will be a long-term position. Education: Bachelor's degree is mandatory English/writing field of study, healthcare administration, history, liberal studies, juris doctorate degree or a related field. Engagement Description The Grievance and Appeals (G&A) Coordinator is responsible for processing appeals, grievances, complaints, and inquiries received from members, authorized representatives, and regulatory agencies. The coordinator is expected to analyze the customer's concerns, conduct necessary research by leveraging various internal and external resources and contacts in order to make appropriate and accurate case decisions. Appeal Coordinators are expected to coordinate, facilitate, and conduct managerial level conferences with customers and their authorized representatives to gather and relay information. The coordinator is expected to keep an accurate documentation record that details steps and action taken to resolve the customer's concerns. The outcome and resolution of all appeals, grievances, complaints, and inquiries is communicated via written correspondence to the customer using clear and simple language and include elements that satisfy corporate, regulatory, and accreditation timeframes, accuracy and response guidelines. Top 3 Required Skills/Experience Analytical mindset- having the ability to examine a matter, the facts, contextual information and make an informed decision or implement a reasonable, rationale solution. Excellent written and verbal communication skills. Must be proficient in proofreading, spelling, grammar, punctuation, and mat Ability to analyze, interpret, apply reason and logic, conduct research, structure a clear and thorough response Required Skills/Experience Ability to apply policies and procedures to arrive at accurate conclusions Ability to work in a fast-paced environment with tight deadlines and high-quality standards Problem solving aptitude Accuracy and strong attention to detail Ability to prioritize responsibilities and effectively manage time Ability to work effectively with management and part of a team to meet targets High regard for protecting confidentiality of member, employee, corporate and performance information. Previous customer service or concierge experience (not specifically in a CSR type role) Strong PC application and system skills- having the ability to navigate multiple computer systems and databases Preferred Skills/Experience Background in writing and/or research Education/Certifications Bachelors degree is required. English/writing field of study, Health Care Administration or related field, history, library studies, Juris Doctorate, etc. Beware of scams. S3 never asks for money during its onboarding process.

Created: 2026-03-10