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Grievance & Appeals Coordinator with Bilingual Experience Must

Hybrid in Rancho Cucamonga, CA, US • Posted 6 days ago • Updated 6 days ago

Contract W2

Hybrid

$20 - $24/hr

Fitment

Dice Job Match Score™

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Job Details

Skills

CMS
DHCS
DMHC
Word
Excel
Outlook
Bilingual

Summary

JOB DESCRIPTION:

Position Title: Grievance & Appeals Coordinator
Client: IEHP

Job Summary:
The Grievance & Appeals Coordinator is responsible for coordinating, tracking, and processing member and provider grievance and appeal cases while ensuring compliance with CMS, DHCS, DMHC, and IEHP regulatory requirements. This role provides administrative support, maintains accurate case documentation, prepares correspondence, monitors case timelines, and collaborates with internal departments to ensure timely resolution of grievances and appeals.

Key Responsibilities:

Process, track, and document member and provider grievance and appeal cases.
Ensure compliance with regulatory guidelines and internal procedures.
Generate and distribute grievance and appeal correspondence within required timelines.
Coordinate with internal departments to obtain information and resolve cases.
Maintain case records, reports, and status updates for management.
Support investigations and case intake activities as assigned.
Communicate with members and providers regarding case-related inquiries.
Assist with process improvement initiatives and departmental goals.

Qualifications:

High School Diploma or GED required.
3+ years of administrative experience in an office environment.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
Strong data entry, organizational, and multitasking skills.
Excellent written and verbal communication skills.
Strong attention to detail and ability to meet deadlines.
Customer service experience and telephone etiquette required.
Bilingual English/Spanish (written and verbal) required for bilingual positions.
Healthcare, managed care, grievances, appeals, or regulatory compliance experience preferred.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 90944144
Position Id: 8992104
Posted 6 days ago

Contact the job poster

Sumanth Parikh

Recruiter @ Synkriom

View Profile

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