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:

• Support the team in processing appeal and grievance requests promptly and efficiently.
• Communicate effectively with the team about special projects and priorities.
• Monitor and distribute incoming faxes and emails to the appropriate departments.
• Review and prioritize written appeals and grievances.
• Enter and document new appeals or grievances received via various channels.
• Assist in obtaining additional information and follow-up as needed.
• Maintain accurate documentation of all communications and actions.
• Coordinate meetings, including scheduling, invites, agendas, and minutes.
• Provide administrative support to the Appeals and Grievances Supervisor and Utilization Operations Director.

Qualifications:

• High School Diploma.
• 6 months of experience in an administrative role.
• 1 year of experience in a customer service role.
• Previous experience in the healthcare industry and with Facets and Salesforce is a plus.
• Intermediate computer skills, including email, database activity, word processing, and spreadsheets.

Sacramento, CA 95833 Monday to Friday 8am - 5pm

potential to go hybrid

3+ contract covering for a leave

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