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Grievance Coordinator

Company: VirtualVocations
Location: Fullerton
Posted on: November 19, 2024

Job Description:

A company is looking for a Grievances & Appeals Coordinator responsible for managing grievances referred by health plan partners.



Key Responsibilities

Handle assigned grievances, ensuring timely acknowledgment and resolution while complying with regulatory requirements
Investigate and resolve issues reported through the grievance portal, coordinating with internal departments and providers
Maintain complete documentation for appeal and grievance cases and address fraud and abuse allegations as necessary


Required Qualifications

High School Diploma or equivalent
1-2 years of experience in appeals and grievance, utilization management, or member services preferred
Proficiency in Excel, Word, and Access
Bilingual skills are a plus
Ability to work in a fast-paced and constantly changing environment

Keywords: VirtualVocations, Rancho Cucamonga , Grievance Coordinator, Other , Fullerton, California

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