Job Details

Your Role

The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints for our Commercial line of business. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to incoming appeals and grievances within established compliance timeframes.

Your Knowledge and Experience

• Requires a high school diploma or GED
• Requires at least 4 years combined operations experience such as I&B, Claims, Customer Services, Regulatory Affairs; of which at least 1 year of direct experience is in Appeals/Grievances, or similar combination
• Requires knowledge of Microsoft Systems such as Power Point, Excel, and Word
• Commercial appeals and grievances knowledge or experience preferred
• Note: You may be placed in a specialty client, or other unit, such as CalPERs.