California Grievance Coordinator

Job Summary

A company is looking for a Grievance & Appeals Coordinator to analyze and resolve claims and authorization appeals.

Key Responsibilities

• Gather, analyze, and report on member and provider complaints, grievances, and appeals
• Prepare response letters for complaints, grievances, and appeals
• Maintain files on individual appeals and grievances and support related programs

Required Qualifications

• High school diploma or equivalent; Associate's degree preferred
• 2+ years of experience in grievance or appeals, claims, or related managed care
• Experience in data entry and managing large volumes of documents
• Knowledge of HEDIS production functions is a plus
• Candidate must reside in California, preferably in or around Sacramento