Grievance and Appeals Coordinator
Location: Sacramento, CA or Woodland Hills, CA Hours: 8:00 a.m. to 5:00 p.m. with possible overtime Rate: $22.00 per hour Please apply online for consideration!
salary: $21 - $22 per hourshift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities- Process and resolve member appeals and grievances with accuracy and timeliness, ensuring quality standards meet or exceed 97%.
- Collaborate with team members and members to provide clear communication and essential case support.
- Identify opportunities for process improvement, contributing to enhanced operational efficiency and customer satisfaction.
- Screen incoming complaints, conduct root cause analysis, create plan of action, coordinate and communicate resolution.
- Communicate with members, providers and regulators regarding decisions and actions.
- Maintain attention to detail and problem-solving skills in a fast-paced, team-oriented environment.
- Claims
- Healthcare
- Customer Service
- Medicare/Medicaid
- Written Communication
- Verbal Communication
- Years of experience: 2 years
- Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).
This posting is open for thirty (30) days.
Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.
Qualified applicants in the unincorporated areas of Los Angeles County with criminal histories will be considered for employment in accordance with the Los Angeles County's Fair Chance Ordinance for Employers.
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.