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Appeals and Grievances Coordinator - 246568

MedixGlendale, California, United States

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Health Services Specialist I – Appeals & Grievances

Location : Onsite to start, Hybrid after training

Schedule : Monday – Friday, 8 : 30 AM – 5 : 00 PM (flexible by ~30–60 minutes)

About the Role

We are seeking a Health Services Specialist I to support the Managed Care Operations team. This role is ideal for someone who has experience in healthcare appeals and grievances (A&G) and is looking for an opportunity to grow with a well-respected organization.

This position will begin onsite for training (2–4 weeks) and then transition to hybrid :

Initially 4 days onsite / 1 remote (or 3 in / 2 out)
Potentially 2 days onsite / 3 remote once performance is established

There is a strong possibility of a Contract-to-Hire opportunity based on performance and volume needs.

Day-to-Day Responsibilities

Review, document, and coordinate appeals and grievances from health plans.

Manage assigned cases through SharePoint , ensuring deadlines are met.

Conduct daily outreach calls to provider offices for coordination of best site of service for outpatient surgeries.

Notify providers with new referrals when member eligibility status has changed.

Track and document all activities accurately.

Monitor the group grievance email and prioritize assignments based on due dates.

Collaborate with team members to support case volume as needed.

Assist with process improvements and support ongoing workflow initiatives.

Required Qualifications

Minimum 2 years of experience in healthcare related to grievances, care coordination, or member services.

Basic knowledge and understanding of Appeals & Grievances (A&G).

Strong organizational skills with the ability to prioritize time-sensitive work.

Proficient in Microsoft Office (Word, Excel, PowerPoint).

Excellent verbal and written communication skills.

Comfortable making and receiving provider calls daily.

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Appeal And Grievance • Glendale, California, United States