Appeals Coordinator Resume

[First Name] [Last Name]

Contact Address: [street] [Country] [City] [State/Province] [Zip Code]

Contact Number: (012)-345-6789

Email Address: [[email protected]]

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Career Objective:

To work as an appeals coordinator and provide satisfactory answers and feasible solutions to grieving patients and ensure quality medical care for them.

Summary of Skills:

  • Comprehensive knowledge of medical terminology and health care customer service
  • Familiarity with CPT/HCPC and ICD9 coding, guidelines and procedures
  • Sincere, punctual, detail-oriented, and self-motivated individual
  • Efficient at performing administrative and clerical functions
  • Possess a sense of responsibility and high regards to ethical behavior
  • Outstanding verbal and written communication
  • Maturity to maintain confidentiality and healthy work relationships with patients and coworkers
  • Ability to comply with Health Insurance Portability and Accountability Act (HIPSS)

Work Experience:

Appeals Coordinator
Columbus Redressal Forum, Columbus, OH
August 2013 – Present

  • Make a note of the complaints registered against different hospitals within the city
  • Evaluate eligibility of cases and admit suitable cases for evaluation
  • Send compliant reports to hospitals and demand explanations for complaints registered
  • Conduct investigations to check for negligence on part of medical teams
  • Conduct meetings with both parties to find feasible solution for grievances
  • Advise legal action against cases for medical negligence and billing mistakes
  • Take suitable action against the offending members and provide compensation to grieving patients

Appeals Coordinator
Noble Hospital, Columbus, OH
May 2012 – July 2013

  • Responded to complaints filed by patients and their family members and helped them understand the complexities
  • Explained process of levying expenses and computation methods adopted to draft bills and justify final amount
  • Made changes to figures in invoices in case of genuine overcharging or undercharging
  • Reported cases of mistakes or negligence by medical staff to higher authorities
  • Entered details of complaints and requests into computer systems and prepared documentation for further process
  • Assured timely intervention and arbitration according to state and federal healthcare guidelines


  • Bachelor’s Degree in Business Management
    Columbus University, Columbus, OH


On request.

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