California Licensed Grievance Coordinator

Job Summary

Analyzing and resolving verbal and written claims and authorization appeals, the full-time California Licensed Grievance Coordinator will manage grievances from members and complaints from providers in a remote setting.

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 pay-for-performance 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 healthcare or behavioral health preferred