{"id":2031439,"url":"https://alion.io/job/lucet-appeals-coordinator","title":"Appeals Coordinator","company":{"id":2018415,"name":"Lucet","domain":"lucethealth.com","url":"https://alion.io/company/lucethealth","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"UltiPro","truth_index":null},"role":"Administrative","role_family":"Administrative","seniority":"middle","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":41000,"max_usd":74000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":115},"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Agile","optional":false},{"name":"Microsoft Office","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-10-07T14:16:17Z","employer_posted_date":"2026-10-07","last_verified_at":"2026-10-12T16:00:58Z","board_verified":true,"closed_at":null,"days_open":5,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":5},"description":"Who We Are\nAt Lucet, we’re transforming whole-person care. We deliver integrated behavioral and physical health solutions that connect individuals to the right care at the right time-improving outcomes and overall well-being. Serving over 15 million lives across the U.S. and Puerto Rico, our model combines clinical expertise, compassionate care, and innovative technology to support healthier, more fulfilling lives.\nAs part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.\nWhy Join our Team\nAt Lucet, we’re committed to creating a workplace where top talent thrives both personally and professionally. We offer a dynamic, mission-driven environment where your work has real impact, your unique background and experience are valued, and no two days are alike. If you’re passionate about meaningful work and delivering impactful results, we encourage you to apply!\nWe support our team with a competitive compensation and benefits package, including:\nHourly compensation between $22.15 to $24, PLUS an annual performance-based, discretionary incentive. *Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.\n\nComprehensive health benefit options: Medical, dental, and vision coverage\n\n401(k) with competitive employer match\n\nCompany-paid life and disability insurance\n\nPaid parental leave and wellbeing incentives\n\nGenerous paid time off, including volunteer time\n\nFlexible spending accounts for healthcare and dependent care\n\nProfessional development opportunities and tuition reimbursement\n\nRemote work flexibility (role-dependent)\n\nOpportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.\n\nAt Lucet, your work will directly support our mission to improve behavioral, physical, and social health-one member at a time.\nWhat You Will Do - Essential Functions\nThe Appeals Coordinator processes and documents all aspects of appeal cases including receipt date and time of an appeal, full investigation of the substance of the appeal and any records, written comments or information pertaining to the appeal. This position requires understanding standards set forth by the National Committee for Quality Assurance (NCQA), the Utilization Review Accreditation Commission (URAC), Department of Labor (DOL), Centers for Medicare and Medicaid Services (CMS), Federal and State laws. The Appeals Coordinator position is accountable for understanding Member and Provider Rights and Responsibilities and structure surrounding claims and appeals. The Appeals Coordinator interfaces with members, providers and clients. The Appeals Coordinator is responsible for assisting the Appeals Specialists with the day-to-day operations of the Appeals Department.\nAppeals Administration Process, research, and document appeals and claims in compliance with regulatory requirements, business rules, and department guidelines to support accurate determinations and issuance of compliant notices.\n\nMonitor appeal workflows and turnaround times, while ensuring complete, accurate case documentation and supporting timely resolution of cases.\n\nCollaboration & Communication Collaborate with Appeals Specialists, customer service, and reimbursement teams to ensure appeals and claims are processed accurately, in compliance with policies, and resolved within required timeframes.\n\nCommunicate effectively with members, providers, health plans, and internal stakeholders, escalating issues as needed to support timely resolution and positive outcomes.\n\nCompliance & Quality Maintain compliance with NCQA, URAC, CMS, DOL, and federal, state, and local regulations while adhering to organizational policies, ethical standards, and confidentiality requirements.\n\nConsistently meet productivity, accuracy, and turnaround time goals for appeal cases while upholding company values and compliance expectations.\n\nWho You Are\nRequired QualificationsAssociates degree and 1+ year of relevant healthcare experience.\nEquivalent combination of education and relevant healthcare appeals, claims, utilization management, or health plan experience may be considered in lieu of a degree including high school diploma with 3+ years’ of relevant healthcare experience.\n1+ years of healthcare appeals, claims, utilization management or related health plan experience.\nProficient in Microsoft Office (Word, Excel, Outlook. Etc.) and appeals documentation system\nDemonstrated knowledge of applicable federal and state regulations, accreditation standards, privacy, confidentiality, and security requirements related to healthcare information.\nAbility to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.\n\nLiving our Values:\nServing everyone with compassion and leading with empathy.\nStepping up and creating value by taking charge and acting when there is an opportunity.\nAdapting in a changing world by recognizing our responsibility to be agile and respond quickly.\nNurturing growth and belonging by respecting and celebrating everyone for who they are.\n\nCompetencies\nDemonstrated flexibility and adaptability to changing processes and various software programs.\nAbility to manage multiple priorities in a fast-paced environment\nProfessional demeanor and ability to work collaboratively with multiple levels of professionals and line staff\nActively participate in and positively contribute to team processes and lead team activities\nExcellent problem-solving, organizational and attention to detail skills.\n\nWorking Conditions:\nWork is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.\nA quiet workspace with minimal background noise for calls.\nHigh-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.\nFrequent use of computer and phone systems\nMust be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.\nTravel between multiple residences or remote work locations is not supported for this position; employees must establish and work consistently from a single designated home office.\n\nWe encourage applicants from a variety of backgrounds and experiences to apply, especially those who can demonstrate how their unique qualifications and skills align with the requirements of this role and support our mission to improve whole-person health.\nThis position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.","description_format":"text","description_chars":7738,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":["Home office","Parental leave","Professional development"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Care","Psychiatric Care"],"lifecycle":[{"event":"open","at":"2026-10-07T14:26:58Z"}],"visa":[],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":4,"expected_fill_days":27,"reasons":["conf:3","win:early"],"computed_at":"2026-10-12T06:55:09Z"},"pay":null,"html_url":"https://alion.io/job/lucet-appeals-coordinator","json_url":"https://alion.io/job/lucet-appeals-coordinator.json","meta":{"generated_at":"2026-10-12T20:19:34Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":32986,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-13T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":2018415},"rest":"https://alion.io/mcp/rest/get_company?id=2018415"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Flucet-appeals-coordinator"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Flucet-appeals-coordinator"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Flucet-appeals-coordinator"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/lucet-appeals-coordinator\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Flucet-appeals-coordinator"}]}