Grievance & Appeals Coordinator I

Position Purpose

Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

Education/Experience

• High school diploma or equivalent.
• Associate's degree preferred.
• 2+ years grievance or appeals, claims or related managed care experience.
• Strong oral, written, and problem-solving skills.

Responsibilities

• Gather, analyze, and report verbal and written member and provider complaints, grievances, and appeals.
• Prepare response letters for member and provider complaints, grievances, and appeals.
• Maintain files on individual appeals and grievances.
• May coordinate the Grievance and Appeals Committee.
• Support pay-for-performance programs, including data entry, tracking, organizing, and researching information.
• Assist with HEDIS production functions, including data entry, calls to provider's offices, and claims research.
• Manage large volumes of documents, including copying, faxing, and scanning incoming mail.

Additional Skills & Qualifications

• Required Experience: At least 1+ years' experience with Grievance & Appeals.
• Regulatory Knowledge: CMS, Medicaid, NCQA.
• Disqualifiers: Lack of healthcare or managed care experience, poor attention to detail, weak communication skills, inexperience with grievance and appeals or UM-related roles, lack of critical thinking and problem-solving skills, and poor time management.
• Additional Qualities: Previous grievance and appeals or UM prior authorization experience, regulatory knowledge, critical thinking/problem-solving with independent work, organizational skills, adaptability, and professionalism. This is a production environment. Interpersonal skills. Technology proficiency.

Experience Level

Entry Level

Job Type & Location

• This is a Contract to Hire position.
• Location: Atlanta, GA.

Pay and Benefits

• Pay Range: $22.50 - $22.50/hr.
• Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.
• If eligible, the benefits available for this temporary role may include:
  • Medical, dental & vision
  • Critical Illness, Accident, and Hospital
  • 401(k) Retirement Plan (Pre-tax and Roth post-tax contributions available)
  • Life Insurance (Voluntary Life & AD&D for the employee and dependents)
  • Short and long-term disability
  • Health Spending Account (HSA)
  • Transportation benefits
  • Employee Assistance Program
  • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Apr 30, 2026.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.