Demo

Grievance Resolution Specialist

HealthCare Support
Orange, CA Temporary
POSTED ON 2/8/2025
AVAILABLE BEFORE 5/8/2025

Grievance Resolution Specialist

HealthCare Support is actively seeking a Grievance Resolution Specialist to fill an opening with a Managed Care Company in Orange, CA . This role is 100% in office and up to 6 month contract assignment, conversion to perm not guaranteed.

Daily Responsibilities for Grievance Resolution Specialist :

  • The Grievance Resolution Specialist will be responsible for coordinating the grievance and appeal resolution process.
  • The incumbent will respond to verbal and written grievances and appeals from members and providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions and pharmacy and vision decisions.
  • The incumbent will have frequent external contact with members and families, health care providers, health networks, third party administrators and regulators.

Required Qualifications for Grievance Resolution Specialist :

  • High School diploma or GED
  • 2 years of true grievance and appeals or claims experience
  • Familiar with Grievances and Appeals, Claims, Regulatory Compliance, and Customer Service
  • Ability to work M-F, any 8 hour shift between 7am-8pm
  • Ability to work 100% in Office
  • Preferred Qualifications for Grievance Resolution Specialist :

  • Associates or Bachelor's Degree
  • Experience working for another health insurance plan / MCO
  • Bilingual in Arabic, Farsi, Chinese, Korean, Spanish, and / or Vietnamese
  • Benefits for Grievance Resolution Specialist :

  • Immediate enrollment in Health Insurance
  • Dental Insurance
  • Life Insurance
  • Employee Assistance Program (EAP)
  • Access to Investment Accounts
  • Career and educational tools within our Ingenovis ACT (Advocacy) Program
  • Pay Details : $25.87 to $38.80 an hour

    Interested in being considered?

    If you are interested in applying to this position, please click Apply Now for immediate consideration.

    For additional consideration, please email a copy of your resume to dennis.lorence@healthcaresupport.com with your phone number, the position title and location, and our recruiters will reach out.

    Healthcare Support Staffing, LLC. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

    Mng #slv225

    Salary : $26 - $39

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