Grievance & Appeals Coordinator I

Job Description



A-Line Staffing is hiring a Grievance & Appeals Coordinator in the Natomas or Woodland Hills, CA area. This is Full-Time 40 hours per week with a Major Healthcare Company!


Job Title: Grievance & Appeals Coordinator I Compensation:

• Pay: The pay is $23/hr paid Bi-Weekly
• Benefits are available to full-time employees after 90 days of employment.
• A 401(k) with company match is available after 1 year of service.

Highlights:

• Location: Must be local to Natomas or Woodland Hills, CA Remote but may need to travel to the Centene office for meetings or events
• Hours: The required availability is Monday-Friday 8am-4:30pm
• This is a contract position with potential to convert directly based on attendance, performance, and business needs

Job Responsibilities:

• Coordinate the grievance and appeals process for members.
• Ensure timely responses to grievances and appeals in compliance with regulations.
• Communicate with members regarding the status of their grievances and appeals.
• Maintain accurate records and documentation of grievances and appeals.
• Collaborate with various departments to resolve issues related to grievances.

Requirements:

• 2-3 years of experience in a similar role within appeals and grievances, healthcare administration, or customer service in a regulated environment.
• Attention to detail and accuracy, tech savvy, troubleshooting skills
  Strong communication and collaboration
• Analytical and problem-solving skills, researching skills
• Must have a minimum of a High School Diploma or GED Equivalent
• Computer proficiency with Microsoft Office programs.

Preferred Skills:

• Experience working with complex cases or compliance-related tasks is highly desirable.
• Knowledge of Healthcare Regulations - Understanding of health plan compliance, regulatory requirements, or experience with Medicare/Medicaid guidelines.
• Conflict Resolution Skills - Ability to handle sensitive cases with professionalism and empathy.
• Project Coordination Experience - Exposure to coordinating cross-functional projects or initiatives in a fast-paced environment.
• Good Letter writing skills

Apply now for immediate consideration with Silvana M. with A-Line!


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