Grievance and Appeals Coordinator - Whittier California

Company: VirtualVocations
Location: Whittier, California
Posted On: 02/04/2025

A company is looking for a Coordinator, Grievance and Appeals.



Key Responsibilities

Administer standard and expedited appeals processes in compliance with regulatory standards
Act as the primary investigator for member grievances and appeals, ensuring proper documentation and resolution
Gather documentation and research outcomes for Clients/Plan Sponsors within required timeframes


Required Qualifications

High School Diploma or equivalent required; 2 years post high school education or bachelor's degree preferred
2-3 years of managed care and/or insurance background preferred
Experience with CMS and/or NCQA audits strongly desired
Proven success in documenting case files and managing multiple cases within required timeframes
Ability to interact cooperatively and respectfully with other employees More...

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