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California Grievance Coordinator

7/10/2025

California

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