Grievance Case Manager

Overview :

As a Grievance Case Manager, you will be responsible for communicating with payors, managing the intake of grievances, and responding to the grievances.

The ideal candidate will have excellent writing and organizational skills with a background in dentistry (or healthcare) and the ability to work Monday through Friday at our Corporate Offices in Orange, CA.

About Sonrava :

Sonrava Health is the parent organization of a national family of health and wellness companies, united by a singular dedication to delivering high-quality, convenient and affordable care through innovative provider models, health coverage and product offerings.

A geographically diverse, multi-specialty organization with a unique mix of providers and payors, Sonrava Health is comprised of several companies including Western Dental & Orthodontics, Western Dental Kids, Brident Dental & Orthodontics, Brident Dental Kids, LooksBrite Eye Centers, EyeMax Vision Plan, MIB Insurance Plans, Vital Smiles, Mid-Atlantic Dental Partners, DentalWorks, and Perfect Teeth all united in our commitment to quality, value and innovation in care.

Responsibilities :

Responsible for the data entry intake of and responding to insurance companies regarding grievances, including submitting dental records and a written response addressing the issues raised in the grievance.

Coordinates submission of responses and dental records to various requestors as well as other administrative duties.

Responsible for monitoring and processing communications such as incoming emails and faxes from payors and other non-payor agencies.

Process account adjustments in accordance with established guidelines.

Meet required deadlines.

Assist QM Manager or Department Management with various duties.

Qualifications :

Excellent verbal and written communication.

Ability to work in a regulatory environment with very strict timeliness and accuracy requirements.

Strong problem-solving abilities.

Dedication to excellent service.

Strong organization and follow-up skills.

Team-player mentality.

Knowledge of Microsoft Office (Excel and Word).

Bachelor’s degree or equivalent combination of education and experience.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Sonrava Health offers a competitive benefit package designed to enhance the lives of our team members. Team Members are eligible for benefits based on his or her full-time status :

Paid Time Off (PTO)

Healthcare Insurance (Medical & Dental)

Vision Coverage

401(k)

Professional Training

Career Advancement Opportunities