Arizona Licensed Grievance Coordinator - Anaheim California

Company: VirtualVocations
Location: Anaheim, California
Posted On: 02/06/2025

A company is looking for a Grievance & Appeals Coordinator II.



Key Responsibilities

Review and process member and provider grievances and appeals in accordance with regulations and policies
Collaborate with subject matter experts to prepare cases for medical review and determine potential quality or access issues
Serve as a liaison between members, providers, regulatory agencies, and internal staff regarding grievance and appeal decisions


Required Qualifications

Bachelor's degree in a related field or equivalent experience
2+ years of claims, contracting, or related experience in a managed care environment
Knowledge of federal and state regulations related to grievances and appeals
Experience in preparing cases for medical review
Ability to act as a subject matter expert on grievances and appeals More...

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