Grievance Coordinator

We are currently expanding our team and looking for a **Quality Assurance Specialist** to join us. If you're passionate about healthcare and making a difference in people's lives, this is the job for you

**BASIC JOB PURPOSE**:Quality Assurance Specialist is reponsible for investigating and documenting complaints/grievances received, both internal and external, and to analyze and report trending of grievance categories.

**RESPONSIBILITES/DUTIES BUT NOT LIMITED TO**:

- Receive, record, and respond to complaints/grievances in a friendly and professional matter.
- As part of an investigation, completes outreach to external parties (ex. providers, facilities, members, or other parties) involved in the grievance.
- Evaluates grievance details and proposes recommendation while remaining in compliance with Call the Car policies.
- Maintains knowledge of Call the Car policies in accordance with applicable regulatory requirements and external laws.
- Acts as a liaison between Call the Car departments to coordinate information relevant to a complaint or grievance.
- Completes work within strict deadlines and escalates perceived delays to leadership.
- Writes resolution letters and corresponds with members and providers by phone and in writing.
- Ensure timely communication, follow up, review, and resolution of concerns, complaints, grievances, incidents, injuries, and accidents reported.
- Ensures all departmental goals (including, but not limited to turnaround, production expectations, and quality metrics) are met.
- Collaborates with Quality Management on Quality Assurance workplan to meet requirements.
- Identifies trends and root cause of issues; proposes solutions or escalates ongoing issues to the Lead Quality Assurance Specialist.
- Report needs for internal corrective action to Lead Quality Assurance Specialist.
- Any other duties as assigned by management.

**PREFERRED QUALIFICATIONS**:

- Ability to adapt to a changing environment and handle multiple priorities.
- Ability to work independently or with a team.
- Excellent problem solving, organization, multi-tasking, and time management skills.

**REQUIREMENTS**:

- 1-2 year(s) of relevant working experience in healthcare setting preferred.
- 1-2-year(s) call center experience in a customer service setting preferred.
- Minimum high school diploma or GED required.
- Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook) required.
- Excellent written and verbal communication skills required.
- Must pass a Criminal Background Screening and a Drug Screen.
- Must pass government exclusion list at time of hire and monthly thereafter.

**Work Location**: Diamond Bar, CA. This is an onsite position.

**Working Shifts**: Monday - Friday, 8-hour shift between the hours of 6:00am - 5:30pm

**COVID Vaccine Requirement**: To ensure a safe working environment for our employees, members, and community, Call the Car requires all employees to be fully vaccinated as a term and condition of employment. Proof of COVID-19 vaccination will be required upon date of hire.

**TYPICAL WORKING CONDITIONS**:Office environment. May require working under stress and tight deadlines. The position requires long periods of sitting.

Pay: From $17.00 per hour

Expected hours: 40 per week

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift
- Monday to Friday

**Experience**:

- Healthcare: 1 year (preferred)
- Customer support: 2 years (preferred)

**Language**:

- Spanish (required)

Work Location: In person