Grievance and Appeals Coordinator

Job Summary

Analyzing and resolving verbal and written claims and authorization appeals, the full-time Grievance and Appeals Coordinator will manage complaints and grievances from providers and members while working remotely.

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 grievances or appeals, claims, or related managed care
• Authorization to work in the U.S. without the need for employment-based visa sponsorship
• Reside near Woodland Hills, CA