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Appeals and Grievances Coordinator - 246568

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

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