California Grievance Coordinator

Job Summary

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

Key Responsibilities

• Analyze and resolve verbal and written claims and authorization appeals from providers
• Prepare response letters for member and provider complaints, grievances, and appeals
• Maintain files on individual appeals and grievances

Required Qualifications

• High school diploma or equivalent; Associate's degree preferred
• 2+ years of experience in grievance or appeals, claims, or related managed care
• Experience with data entry and managing large volumes of documents
• Familiarity with HEDIS production functions
• Must reside within the state of California