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Grievance and Appeals Coordinator

1 month ago

Alameda, United States A-Line Staffing Solutions Full time
Job DescriptionJob Description

A-Line Staffing is now hiring a Grievance and Appeal Coordinator in Alameda, CA. The Grievance and Appeal Coordinator would be working for a Fortune 500 company and has career growth potential. This would be full time / 40+ hours per week.

*Must live close enough to the office to work onsite, as need – 2-3 days monthly*

If you are interested in this Grievance and Appeal Coordinator position, please contact Mackenzie Rose at mrose@alinestaffing.com or (586) 710-7966.

Grievance and Appeal Coordinator Compensation

  • The pay for this position is $29.10 -$35 per hour based on experience
  • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Grievance and Appeal Coordinator Highlights

  • The required availability for this position is Monday - Friday 8 - 5 PST
  • *This is a hybrid position* Must live close enough to the office to work onsite, as need – 2-3 days monthly
  • Start Date: As Soon As Possible

Grievance and Appeal Coordinator Responsibilities

  • Thoroughly document the investigation and resolution of each case.
  • Maintain an accurate and complete appeals/grievance record in the electronic database.
  • Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC appeal processes.
  • Ensure compliance with state and federal regulations as they relate to appeal and grievance issues.
  • Serve as the liaison with other departments to resolve grievance issues.
  • Ensure timely communication with the Supervisor on all issues having potential risk and or impact on operations.
  • Engage in special projects as assigned/requested.
  • Other duties as assigned.

Grievance and Appeal Coordinator Requirements

  • High School Diploma or GED
  • Attendance is mandatory for the first 90 days
  • Minimum of one to two year of experience in health services, managed care, hospital, or similar setting, required.
  • Knowledge of managed care and medical terminology;
  • Experience in a customer service or coordination in a healthcare setting or equivalent experience;
  • Excellent verbal and written communications skills;
  • Team player who builds effective working relationships;
  • Strong organizational skills;
  • Proficient experience in Microsoft Word, Excel, Access, Outlook, and PowerPoint; and
  • Excellent verbal and written communication skills a must.

Grievance and Appeal Coordinator Preferred Qualifications

  • Associates and/or bachelor’s degree, preferred.
  • Minimum of one to two year of experience in health services, managed care, hospital, or similar setting, required.

If you think this Grievance and Appeal Coordinator position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting

Mackenzie Rose – Recruiting Assistant

mrose@alinestaffing.com or (586) 710-7966 or Schedule an appointment