Pyramid Consulting, Inc · 4 weeks ago
Grievance & Appeals Coordinator
United States
Full-time
Remote
Entry, Mid Level
$22/hr - $23/hr
2+ years expPyramid Consulting, Inc. is a leading player in the Healthcare Industry, currently seeking a Grievance & Appeals Coordinator for a 12-month contract opportunity. The role involves processing and resolving member appeals and grievances while ensuring compliance with internal policies and regulatory requirements.
ConsultingInformation TechnologyLegalProfessional ServicesSoftwareStaffing Agency
Responsibilities
Process and resolve member appeals and grievances in accordance with internal policies, timelines, and regulatory requirements
Review case documentation for completeness, accuracy, and compliance
Maintain clear and professional communication with internal stakeholders regarding case status and resolution
Draft clear, accurate, and compliant written correspondence related to appeals and grievances
Collaborate with team members on complex cases and contribute to case discussions
Identify trends, issues, or improvement opportunities within case workflows
Support quality initiatives aimed at meeting or exceeding performance benchmarks
Maintain detailed and accurate records within internal systems
Qualification
Required
2-3 years of experience in appeals and grievances, healthcare administration, insurance operations, or another regulated environment
Strong knowledge of federal and state healthcare regulations (Medicare/Medicaid preferred)
Demonstrated letter-writing or formal correspondence experience
Strong attention to detail and accuracy
Effective written and verbal communication skills
Ability to manage multiple cases and deadlines in a fast-paced environment
Knowledge of healthcare regulations, including Medicare and Medicaid guidelines
Experience handling complex or compliance-related cases
Strong conflict resolution and customer service skills
Exposure to cross-functional coordination or project support
Consistently meet or exceed quality benchmarks (approximately 97% accuracy)
Resolve cases within required turnaround times
Demonstrate strong collaboration and proactive communication
Contribute to customer satisfaction through effective case resolution
High School Diploma or GED
Benefits
Health insurance (medical, dental, vision)
401(k) plan
Paid sick leave (depending on work location)
Company
Pyramid Consulting, Inc
Pyramid Consulting, a global leader in workforce and technology solutions, empowers individuals and organizations to transform and thrive in the most challenging and competitive markets.
5001-10000 employees
H1B Sponsorship
Pyramid Consulting, Inc has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (178)
2024 (112)
2023 (95)
2022 (62)
2021 (50)
2020 (117)
Funding
Current Stage
Late StageLeadership Team
Ramesh Maturu
President and Co-Founder
Manish Kaushik
Chief Financial Officer
Recent News
2025-08-18
Company data provided by crunchbase