Job Description
Schedule: The position is 100% Remote, and the candidates must reside in Southern California
Description:
The Temporary Coordinator, Grievance and Appeals supports the administrative and operational functions of the Grievance & Appeals department. This role ensures timely and compliant processing of member and provider grievances and appeals in accordance with regulatory guidelines and internal protocols. Working under the direction of leadership, the Coordinator plays a key role in maintaining compliance, coordinating case workflows, and supporting resolution activities while delivering a high level of service to members and internal stakeholders.
Description:
The Temporary Coordinator, Grievance and Appeals supports the administrative and operational functions of the Grievance & Appeals department. This role ensures timely and compliant processing of member and provider grievances and appeals in accordance with regulatory guidelines and internal protocols. Working under the direction of leadership, the Coordinator plays a key role in maintaining compliance, coordinating case workflows, and supporting resolution activities while delivering a high level of service to members and internal stakeholders.
What You Will Do:
- Coordinate, document, and track all member and provider grievances and appeals
- Ensure cases are processed in compliance with CMS, DHCS, DMHC, and internal guidelines
- Generate and distr...