Complaints Grievances Specialist II

Job Summary

A company is looking for a Complaints & Grievances Specialist II.

Key Responsibilities:

• Investigate and resolve member appeals, complaints, and grievances based on regulatory requirements
• Prepare State Fair Hearing packets and participate in State Fair Hearing reviews
• Monitor and manage department workflow to meet goals and deadlines

Required Qualifications:

• High School Diploma or GED required
• 1 year of C&G experience or 2 years' experience in claims, customer service, or another operational function
• Proficient with Microsoft Excel, Word, and Outlook
• Ability to work in a high-pressure environment and prioritize multiple tasks
• Willingness to work overtime as needed