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Added 25 mins ago
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Associate
RBC
Montreal, QC
- Full-time
By providing ongoing, exceptional service and support to our clients and our advisory team, you will help our team deepen existing relationships and welcome new clients to the firm. As an…
Added 25 mins ago
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Investment Associate
RBC
Montreal, QC
- Full-time
Provide proactive client service with a focus on problem resolution and attention to details. Liaise with various departments for execution, where necessary.
Added 25 mins ago
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Credit Analyst II
TD
Oshawa, ON · Peterborough, ON
- Full-time
Continually deliver exceptional customer service at every interaction and execute on plans to continuously improve the customer experience
Added 25 mins ago
T
PIA Client Service Associate
TD
AB
- Full-time
…value clients? If so, then get onboard for the position of PIA Client Service Associate. In this role, you will provide dedicated specialized administrative support to an Investment Advisor…
Added 25 mins ago
T
Customer Experience Associate - Water Street
TD
St. John's, NL
- Part-time
…with our customers by performing a broad range of customer service transactions and providing information and advice on services, products, and solutions to existing or prospective TD…
Added 25 mins ago
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Bilingual Client Service Associate
BMO
Toronto, ON · YNG
- Full-time
Processes client service requests and administrative requests according to established procedures & policies and submits as required for approval.
Added 25 mins ago
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Administration Associate
BMO
Burnaby, BC
- Full-time
…operations with day-to-day administration and provides exceptional client service to support achievement of business objectives. As this role contributes to the overall success of the…
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Customer Experience Associate
Brambles
Mississauga, ON
- Full-time
Are you ready to take on a dynamic role that puts you at the heart of customer success? As a Customer Experience Associate at CHEP Canada, you’ll be the primary point of contact for…
Added 25 mins ago
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Seasonal Associate
Sephora
Edmonton, AB
- $17 to $20 CAD / hour
As a Seasonal Associate, you’ll be responsible for providing an outstanding client experience by supporting both store operations and onstage service during peak business moments. You’ll…
Added 41 mins ago
Inside Sales Representative
Xerox
Saint John, NB
…Today, Xerox is continuing its legacy of innovation to deliver client-centric and digitally-driven technology solutions and meet the needs of today’s global, distributed workforce. From the…
Added 55 mins ago
Sales Associate
Laura Canada
Ottawa, ON · Nepean, ON
As a Sales Associate in women’s fashion, you possess a passion for fashion and personalized customer service. You will be part of a winning team that provides a unique and memorable…
Added 55 mins ago
RC
Desktop Administrator II, IT Infrastructure
Ryan Companies US, Inc.
Calgary, AB
- Full-time
Tuition Reimbursement After One Year of Service
Added 55 mins ago
R
Associate
RBC
Vancouver, BC
- Full-time
By providing ongoing, exceptional service and support to our clients and our Advisor team, you will help our team deepen existing relationships and welcome new clients to the firm. As an…
Added 55 mins ago
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Associate Advisor
RBC
Laval, QC
- Full-time
RBC Dominion Securities is seeking an Associate Advisor to join a dynamic advisory team specialized in providing wealth management services to a sophisticated clientele. You will deepen…
Added 55 mins ago
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Customer Experience Associate - Future Opportunities
TD
Ottawa, ON
- Part-time
…with our customers by performing a broad range of customer service transactions and providing information and advice on services, products, and solutions to existing or prospective TD…
Added 1 hour ago
MU
Student Recruitment Associate
McGill University
Sainte-Anne-de-Bellevue, QC · Laird Hall
- Full-time
Demonstrated ability to provide professional, responsive, and client-focused service to prospective students, applicants, parents, and other stakeholders.
Added 1 hour ago
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Associate, Client Services
CIBC
Toronto, ON
- Full-time
Reporting to the Director or Team Leader, the Associate, Client Services will conduct client risk assessments, including a thorough review of adverse media and geopolitical risks associated…
Added 1 hour ago
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Intermediate Accountant, Financial Reporting & Insights
BDO
Toronto, ON
- Full-time
Identify and resolve accounting and bookkeeping issues while supporting managers and partners in delivering high-quality client service and meeting deadlines.
Added 1 hour ago
NB
Associate
National Bank of Canada
Trois-Rivières, QC · Greater Trois-Rivieres Metropolitan Area
- Full-time
…wealth advisors to stand out by offering exceptional customer service that will have a positive, long-term impact on our…
Added 1 hour ago
NB
Wealth Associate
National Bank of Canada
Rimouski, QC
- Full-time
A career as an Associate in the Wealth Management team at National Bank, will give you the opportunity to show your ability to work in synergy with clients and colleagues. In this role, you…
Added 1 hour ago
NB
Associate
National Bank of Canada
Quebec, QC
- Full-time
A career as an Associate in the Wealth Management team at National Bank, will give you the opportunity to show your ability to work in synergy with clients and colleagues. In this role, you…
Added 1 hour ago
NB
Senior Wealth Associate
National Bank of Canada
AB · Edmonton, AB
- Full-time
We are seeking an experienced Senior Wealth Associate to serve as a trusted partner to our Wealth Advisors and a key relationship contact for our clients. This is a highly visible,…
Added 1 hour ago
KS
Canada Partner Associate
Kastech Software Solutions Group
Toronto, ON
- $30 to $35 USD / hour
- Contract
The Client team is looking for ambitious, highly motivated bilingual individuals to join our Sales team. As a Bilingual Sales Representative, you will play a key role in growing the Client…
Added 1 hour ago
Campus Recruiter - Senior Associate
EY
Toronto, ON
…the National Campus Recruitment Team, our Human Resources and Client Serving Team Members from our Practices as well as other Service Lines. The Recruiter is responsible for recruiting…
Added 1 hour ago
Donor Centre Associate - Blood Collection
Canadian Blood Services
Nanaimo, BC
Leveraging your superb client service skills and ability to communicate effectively with donors and your team, you will conduct registration and confidential screening to determine…

Jobgether

Appeals Coordinator

Canada

Full-time

Apply About employer

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Job details

Job type: Full-time
Posting language: English
Posted: Oct 6, 2026

Original job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Appeals Coordinator based in Canada.

This role is responsible for coordinating and managing appeal cases while ensuring decisions are handled accurately and within required timeframes. You will maintain a caseload, review medical and clinical documentation, and determine the appropriate administrative or clinical appeal pathway. The position combines case management, data entry, customer communication, documentation, and cross-functional coordination. You will work closely with physician advisers, medical directors, case managers, supervisors, and other stakeholders to resolve complex appeal questions. The role also contributes to reporting, audits, quality improvement initiatives, and employee training. Strong organization, attention to detail, and communication skills are essential for maintaining high standards and regulatory compliance.

Accountabilities

Maintain an assigned caseload and monitor compliance with appeal decision timelines and applicable procedures.
Review clinical and medical records for completeness and determine whether cases require administrative or clinical appeal review.
Coordinate and distribute first-, second-, and third-level appeal assignments to the appropriate reviewers.
Assign cases requiring medical necessity review to physician advisers and medical directors.
Enter accurate appeal and case review information into databases and maintain complete documentation.
Prepare and present appeal information to panels and second-level multidisciplinary committees.
Gather and analyze appeal activity data and support the preparation of internal and external appeals audits.
Participate in quality improvement activities and contribute to the development and implementation of department workflows.
Support training for new employees and help ensure team members understand applicable procedures and performance standards.
Consult with managers and collaborate with case managers, clinical supervisors, account managers, and other personnel to resolve denial and appeal questions.
Respond to member, provider, and client inquiries regarding appeal status, processes, and outcomes.
Organize daily workloads and workflows to ensure appeals are resolved accurately, efficiently, and in accordance with client requirements and applicable regulations.

Requirements

High school diploma or GED required; an associate degree is preferred.
Previous customer service experience, particularly in roles involving direct customer interactions and detailed documentation.
Experience with data entry and case management.
Strong letter-writing, writing, proofreading, and document-review skills, with excellent attention to accuracy and detail.
Proficiency with Microsoft Office and Microsoft Suite applications.
Ability to review and understand health-related materials and handle sensitive information professionally.
Strong interpersonal and communication skills, with the ability to interact effectively with members, providers, clients, and internal stakeholders.
Highly organized and capable of managing multiple cases, priorities, and deadlines effectively.
Ability to recognize when assistance is needed and seek appropriate support on complex or unfamiliar tasks.
Experience in healthcare is a plus.
Customer service experience is valued.
Typing speed of approximately 50 words per minute is preferred.

Benefits

Opportunity to contribute to healthcare appeal and case management operations.
Exposure to clinical, administrative, and regulatory processes within a healthcare environment.
Opportunities to collaborate with multidisciplinary teams and healthcare professionals.
Experience supporting quality improvement, audits, reporting, and workflow initiatives.
Professional development through employee training and involvement in departmental projects.

How Jobgether Works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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More about this job

Responsibilities

Manage an assigned caseload, review medical and clinical documentation, route appeals to appropriate reviewers, and ensure decisions meet required timelines and procedures. Maintain accurate records, respond to member and provider inquiries, support audits and quality improvement, and coordinate with clinical and administrative stakeholders.

Requirements

A high school diploma or GED is required, and an associate degree is preferred; relevant experience includes customer service, data entry, and case management. Candidates should have strong writing, proofreading, communication, organization, and document-review skills, proficiency with Microsoft Office, and the ability to handle health-related materials and sensitive information.

Skills

Appeals Coordination
Case Management
Medical Record Review
Clinical Documentation Review
Data Entry
Customer Service
Written Communication
Proofreading
Attention to Detail
Microsoft Office
Workload Management
Regulatory Compliance
Data Analysis
Audit Support
Cross-Functional Coordination
Quality Improvement

Benefits

Opportunity to Contribute to Healthcare Appeal and Case Management Operations
Exposure to Clinical, Administrative, and Regulatory Processes
Collaboration with Multidisciplinary Teams and Healthcare Professionals
Experience Supporting Quality Improvement, Audits, Reporting, and Workflow Initiatives
Professional Development Through Employee Training and Departmental Projects

Visa sponsorship

Not detected in the job text

Keywords

Appeals
Appeal Case Management
Administrative Review
Clinical Review
Medical Necessity
Medical Records
Clinical Documentation
Physician Advisers
Medical Directors
Multidisciplinary Committees
Case Management
Data Entry
Microsoft Office
Customer Service
Member Inquiries
Provider Inquiries
Appeal Timelines
Regulatory Compliance
Appeals Audits
Reporting
Quality Improvement
Workflow Development
Employee Training
Sensitive Information
Healthcare

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