Appeals and Grievance Specialist

As an Appeals and Grievances Coordinator you'll play a crucial role in efficiently processing appeal and grievance requests, ensuring smooth operations, and maintaining excellent communication.

Responsibilities:

• Process appeals and grievances, ensuring no request goes unnoticed.
  
• Keep the team informed about special projects and priorities, enhancing team collaboration.
  
• Efficiently manage and distribute incoming faxes and emails to the right departments.
  
• Carefully review and prioritize written appeals and grievances for prompt resolution.
  
• Accurately document new appeals or grievances received through various channels.
  
• Assist in gathering additional information and follow up diligently when necessary.
  
• Maintain detailed records of all communications and actions taken.
  
• Arrange and coordinate meetings, manage schedules, send invites, prepare agendas, and take minutes.
  
• Provide invaluable administrative support to the Appeals and Grievances Supervisor and Utilization Operations Director.
  

Qualifications:

• High School Diploma or equivalent.
  
• A minimum of 1 year in a appeals and grievances.
  
• Experience in the healthcare industry and familiarity with Facets and Salesforce is a bonus.
  
• Proficient with computers, including email, databases, word processing, and spreadsheets.
  
• Ability to type 40WPM
  

This position is onsite Monday to Friday 8am-5pm

Pay Details: $18.00 to $20.50 per hour

Search managed by: Joanna Calderon

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance