Provider Disputes and Appeals Intake Coordinator (Hybrid)- Pittsburgh, PA

Are you detail-oriented, organized, and passionate about supporting fair outcomes in healthcare? Join our team as a Provider Disputes & Appeals Intake Coordinator, where your work ensures that provider concerns are handled accurately, efficiently, and with care. In this role, you’ll be at the heart of our appeals process managing case intake, maintaining data integrity, and helping providers navigate their disputes with clarity and confidence. The Intake Coordinator will manage accurate and timely case entry and classification in the Provider Disputes and Appeals information system. Accurately maintain provider dispute data files.

This is a full time position working Monday through Friday daylight hours. This is a hybrid role. Candidates will need to travel to the office for training and/or department business needs.

Responsibilities:

• Conduct case intake process, via cases received through written requests, and set up new cases in the C&G information system.
• Classify provider complaints/appeals based online of business and appeal rights by completing appropriate investigation with may include outbound contact, as needed.
• Access multiple health plan systems to assist with case classification.
• Accurately and promptly assess, enter and maintain documents in files and/or databases to assure that information is organized and readily available.
• Respond and address incoming messages via department inboxes, emails, or faxes in an accurate and prompt manner.
• Triage and respond to inquiries as appropriate or distribute as needed.
• Retrieve, copy, collate, and file various documents associated with the provider dispute and appeal processes.
• Identify and escalate priority and expedited issues to management within a timely manner.
• Support the team's efforts to improve performance against measured service operation goals.
• Complete data entry into various information systems to support C&G processes.
• Support implementation of appeals tracking system.