Who We Are
At 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.
As 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.
[https://marketing.lucet.health/hubfs/Social-Media/HR-Job-Postings/Lucet-BH-Job-Posting-Image-1.jpg]
Why Join our Team
At 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!
We support our team with a competitive compensation and benefits package,
including:
Hourly 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.
Comprehensive health benefit options: Medical, dental, and vision coverage
401(k) with competitive employer match
Company-paid life and disability insurance
Paid parental leave and wellbeing incentives
Generous paid time off, including volunteer time
Flexible spending accounts for healthcare and dependent care
Professional development opportunities and tuition reimbursement
Remote work flexibility (role-dependent)
Opportunity for meaningful growth, both personally and professionally, where
your unique background and experience is welcomed and valued.
At Lucet, your work will directly support our mission to improve behavioral,
physical, and social health—one member at a time.
What You Will Do - Essential Functions
The 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.
Appeals 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.
Monitor appeal workflows and turnaround times, while ensuring complete,
accurate case documentation and supporting timely resolution of cases.
Collaboration & 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.
Communicate effectively with members, providers, health plans, and internal
stakeholders, escalating issues as needed to support timely resolution and
positive outcomes.
Compliance & Quality
Maintain compliance with NCQA, URAC, CMS, DOL, and federal, state, and
local regulations while adhering to organizational policies, ethical
standards, and confidentiality requirements.
Consistently meet productivity, accuracy, and turnaround time goals for
appeal cases while upholding company values and compliance expectations.
Who You Are
Required Qualifications
Associates degree and 1+ year of relevant healthcare experience.
Equivalent 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.
1+ years of healthcare appeals, claims, utilization management or related
health plan experience.
Proficient in Microsoft Office (Word, Excel, Outlook. Etc.) and appeals
documentation system
Demonstrated knowledge of applicable federal and state regulations,
accreditation standards, privacy, confidentiality, and security
requirements related to healthcare information.
Ability 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.
Living our Values:
Serving everyone with compassion and leading with empathy.
Stepping up and creating value by taking charge and acting when there is an
opportunity.
Adapting in a changing world by recognizing our responsibility to be agile
and respond quickly.
Nurturing growth and belonging by respecting and celebrating everyone for
who they are.
Competencies
Demonstrated flexibility and adaptability to changing processes and various
software programs.
Ability to manage multiple priorities in a fast-paced environment
Professional demeanor and ability to work collaboratively with multiple
levels of professionals and line staff
Actively participate in and positively contribute to team processes and
lead team activities
Excellent problem-solving, organizational and attention to detail skills.
Working Conditions:
Work 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.
A quiet workspace with minimal background noise for calls.
High-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.
Frequent use of computer and phone systems
Must 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.
Travel 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.
We 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.
This 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.