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Open Position: (1) G&A Coordinator
Reason for opening:
- They have a significant increase of inventory and it has not tapered off. They anticipate this being consistent and the new amount of workload
Start Date: 7/28//2025
Contract: 6 month CTH
HARD Requirements:
- Medicaid background (AHCCCS)
- Appeals/Grievance, appeals processor, member facing exp.
Certifications:
- N/A
Equipment:
- Laptop issued from Banner
Location:
- Fully remote (Only AZ candidates)
Assessment:
- N/A
Metrics:
- 4-5 intake cases per hour
- Closures: 5-6 per hour
Applications:
- N/A
Interview Process:
- 30 min virtual interview
Team Size:
- work with 13 other coordinators
CORE FUNCTIONS
1. Maintains State Fair Hearing Logs with appropriate information required by HP policy, AHCCCS, HCG
and CMS regulations.
2. Reviews all State Fair Hearing requests by members and providers, pulls case files, meets with
Grievance & Appeals Manager for further review and action which may include collaboration with others to
avoid/reduce grievances, appeals and/or claim disputes. May attend State Fair Hearings.
3. Coordinates and assists the Grievance & Appeals Manager in preparing for higher level of appeals (i.e.
Independent Review Entity reviews, hearings, etc.) including telephonic requests.
4. Assists with project management of departmental improvements. Coordinates with other departments on
Grievance & Appeals projects/workgroups.
5. Assists the Marketing Department with the production of all member letters and notices. Participates
actively in meetings, workgroups and committees relevant to the Grievance & Appeals process. May
produces, prepare, quality check or deliver all reporting requirements in the absence of the Grievance &
Appeals Manager.
6. Produces and analyzes weekly and monthly data to determine trends and provides recommendations for
intervention. Assists with internal, external and self-audits of department and annual data validation.
7. Produces Monthly Operational Dashboard. Produces, analyzes and reports monthly data to ensure
regulatory compliance. Updates Grievance & Appeals data in conjunction with the Marketing department on
all HP websites.
8. Monitors and resolves member and provider expedited appeals and grievances received after hours
and/or holidays when assigned to rotational on-call duty. Coordinates appropriate action by supporting
clinical staff for processing of member and provider expedited appeals and/or grievances.
9. This position works under supervision, prioritizing data from multiple sources to provide quality care and
support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on
customer service. Interacts with staff at all levels throughout the organization.
MINIMUM QUALIFICATIONS
- High school diploma/GED or equivalent working knowledge. Two years of work experience in health care related field or experience managing projects/initiatives, or an equivalent combination of education and experience
- Three to four years of grievance and appeal work in a health care environment, or an equivalent combination of education and experience. Maintains knowledge of AHCCCS, HCG, and CMS regulations by participating in training, teleconferences and services.
Medasource is an equal opportunity employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, lactation and related medical conditions), gender identity or gender expression, sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances.
Benefits & Perks:
Medasource offers competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage with plans that can fit each employee’s needs. We offer a 401k plan that includes a company match and is fully vested after you become eligible, paid time off, sick time, and paid company holidays. We also offer an Employee Assistance Program (EAP) that provides services like virtual counseling, financial services, legal services, life coaching, etc.
Pay Disclaimer:
The pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.
JO-2507-173186