United States · Remote Solely
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Grievance Management, Appeals Coordination, Regulatory Compliance, Investigation, Case Management
Bengaluru, Karnataka, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Healthcare BPM, US Healthcare Operations, RPA, Artificial Intelligence, Machine Learning
Bengaluru, Karnataka, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Healthcare BPM, US Healthcare Operations, RPA, Artificial Intelligence, Machine Learning
Bengaluru, Karnataka, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Healthcare BPM, Contact Center Operations, Robotic Process Automation, Artificial Intelligence, Machine Learning
Port Blair, Andaman and Nicobar Islands, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Real Time Analysis, Workforce Management, Intraday Monitoring, SLA Management, Data Analysis
Hyderabad, Telangana, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Workforce Analytics, Forecasting, Capacity Planning, Statistical Analysis, Data Modeling
Bedford, Indiana, United States · On-site
$18/hr–$22/hr
Advertisement Closes: 07/02/2026 12:00 AM Pay Grade: Non-Merit Grade Salary: $7.25 - $50.00 Hourly Time Type: Full time Health Department: Lawrence County Health Department Summary: This full-time position will lead the …
Skills: Coalition Building, Community Engagement, Project Management, Strategic Planning, Youth Engagement
Fleming County, Kentucky, United States · On-site
$28/hr–$35/hr
Advertisement Closes: 06/28/2026 12:00 AM Pay Grade: Grade 23 Salary: $28.79 - $35.81 Hourly Time Type: Full time Health Department: Fleming County Health Department Summary: Provides direct supervision of assigned nursi…
Skills: Nursing Supervision, Program Management, Performance Evaluation, Quality Improvement, Clinical Decision Making
United States · On-site
$17/hr–$21/hr
Advertisement Closes: 06/28/2026 12:00 AM Pay Grade: Grade 14 Salary: $17.04 - $21.19 Hourly Time Type: Full time Health Department: Fleming County Health Department Summary: Provides personal assistance, administrative …
Skills: Administrative Support, Budgeting, Personnel Planning, Office Management, Research
Bengaluru, Karnataka, India · On-site
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Healthcare BPM, Contact Center Operations, Robotic Process Automation, Artificial Intelligence, Machine Learning
United States · On-site
Advertisement Closes: 08/30/2026 12:00 AM Pay Grade: Non-Merit Grade Salary: $7.25 - $50.00 Hourly Time Type: Full time Health Department: Purchase District Health Department Summary: Dentist Contracted Partial-Year / Fu…
Skills: Restorative Dentistry, Pediatric Dental Care, Dental Screenings, Patient Record Management, Oral Health Education
Fleming County, Kentucky, United States · On-site
$22/hr–$28/hr
Advertisement Closes: 06/28/2026 12:00 AM Pay Grade: Grade 19 Salary: $22.81 - $28.36 Hourly Time Type: Full time Health Department: Fleming County Health Department Summary: This incumbent performs tasks relating to the…
Skills: Office Management, Fiscal Management, Budgeting, Purchasing, Inventory Control
United States · On-site
$19/hr–$23/hr
Advertisement Closes: 06/28/2026 12:00 AM Pay Grade: Grade 16 Salary: $19.15 - $23.82 Hourly Time Type: Full time Health Department: Fleming County Health Department Summary: Supervises a program(s) that typically perfor…
Skills: Program Administration, Organizational Analysis, Budgeting, Contract Management, Facility Management
Kingston, Jamaica · Hybrid
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Procurement Strategy, Strategic Sourcing, Vendor Management, Contract Negotiation, Cost Optimization
Bengaluru, Karnataka, India · Hybrid
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patie…
Skills: Solution Architecture, U.S. Healthcare Operations, BPO Operations, Revenue Cycle Management, Business Process as a Service
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The coordinator manages and resolves member and provider complaints, grievances, and appeals. They conduct comprehensive investigations and ensure all responses adhere to state and federal regulatory requirements.
The candidate must be able to perform non-biased investigations and thoroughly document all actions taken to resolve issues. Proficiency in navigating healthcare regulatory standards for appeals and grievances is required.
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job Description:
The Appeals and Grievance Coordinator will be responsible for managing, coordinating, and resolving member and provider complaints, grievances, and appeals, ensuring compliance with state and federal regulatory requirements. Our Appeals and Grievance Coordinator will act as the primary investigator and contact person for the member and provider and perform research, resolution, and response to complaints on behalf of a member.
Responsibilities:
· Sending appropriate acknowledgment of the grievance/appeal; educating the member or provider about the grievance/appeal process and their right to appeal to state or federal agencies (if applicable)
· Gathering all relevant information from the member or provider regarding the grievance/appeal and determining the appropriate resolution of the grievance/appeal per standard policies and procedures.
· Notifying the appropriate parties of the resolution and ensuring that all internal processes are completed to resolve the issue
· Conducts non-biased, accurate, timely, and comprehensive investigation of all the facts related to the grievance/appeal
· Thoroughly documents all action taken on behalf of the member or provider to resolve the grievance/appeal.
· Ensures that all grievances/appeals are processed in adherence to state and federal regulations
Sagility is the foremost expert in healthcare operations with over 25 years of experience across the entire value chain—upstream, midstream, and downstream. We combine deep domain expertise, tech-led transformation, and trusted collaboration to help healthcare organizations achieve operational excellence and deliver better outcomes. • 𝐃𝐞𝐞𝐩 𝐃𝐨𝐦𝐚𝐢𝐧 𝐄𝐱𝐩𝐞𝐫𝐭𝐢𝐬𝐞: We understand healthcare operations like no one else. Our knowledge is embedded in every process, enabling us to create meaningful value for payers, providers, and other stakeholders. • 𝐓𝐞𝐜𝐡-𝐋𝐞𝐝 𝐓𝐫𝐚𝐧𝐬𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧: Transformation is more than deploying point solutions or isolated AI use cases. We reimagine end-to-end workflows, architecting integrated designs that drive efficiency, scalability, and innovation. • 𝐓𝐫𝐮𝐬𝐭𝐞𝐝 𝐂𝐨𝐥𝐥𝐚𝐛𝐨𝐫𝐚𝐭𝐢𝐨𝐧: We build on the trust our clients place in us by fostering a robust ecosystem of partners—including consulting firms, software providers, platform companies, system integrators, and cloud innovators—to deliver comprehensive solutions delivering higher ROI. At Sagility, we are mastering the art of leading with AI-first mindset that is grounded in compliance powered by the passion of our people to deliver value across the continuum of healthcare operations. With a presence across 5 countries and a strong workforce of nearly 45,000 employees, we bring global scale and expertise to every engagement.
Offices: 3455 Peachtree Rd NE, Suite 700, Atlanta, Georgia 30326, US
Sagility is the foremost expert in healthcare operations with over 25 years of experience across the entire value chain—upstream, midstream, and downstream. We combine deep domain expertise, tech-led transformation, and trusted collaboration to help healthcare organizations achieve operational excellence and deliver better outcomes. • 𝐃𝐞𝐞𝐩 𝐃𝐨𝐦𝐚𝐢𝐧 𝐄𝐱𝐩𝐞𝐫𝐭𝐢𝐬𝐞: We understand healthcare operations like no one else. Our knowledge is embedded in every process, enabling us to create meaningful value for payers, providers, and other stakeholders. • 𝐓𝐞𝐜𝐡-𝐋𝐞𝐝 𝐓𝐫𝐚𝐧𝐬𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧: Transformation is more than deploying point solutions or isolated AI use cases. We reimagine end-to-end workflows, architecting integrated designs that drive efficiency, scalability, and innovation. • 𝐓𝐫𝐮𝐬𝐭𝐞𝐝 𝐂𝐨𝐥𝐥𝐚𝐛𝐨𝐫𝐚𝐭𝐢𝐨𝐧: We build on the trust our clients place in us by fostering a robust ecosystem of partners—including consulting firms, software providers, platform companies, system integrators, and cloud innovators—to deliver comprehensive solutions delivering higher ROI. At Sagility, we are mastering the art of leading with AI-first mindset that is grounded in compliance powered by the passion of our people to deliver value across the continuum of healthcare operations. With a presence across 5 countries and a strong workforce of nearly 45,000 employees, we bring global scale and expertise to every engagement.
Offices: 3455 Peachtree Rd NE, Suite 700, Atlanta, Georgia 30326, US
