Grievance and Appeals Coordinator
Company: VirtualVocations
Location: Whittier
Posted on: February 2, 2025
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Job Description:
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
Keywords: VirtualVocations, Highland , Grievance and Appeals Coordinator, Other , Whittier, California
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