California Licensed Clinical Grievance Coordinator

Job Summary

A company is looking for a Clinical Grievance Coordinator.

Key Responsibilities

• Receive and evaluate grievance documentation and determine necessary details
• Make outbound calls to members and providers to clarify grievance information and manage the case process
• Complete grievance review procedures according to regulatory or contractual requirements

Required Qualifications

• High School Diploma/GED (or higher)
• 2+ years of experience working with appeals and grievances in healthcare
• 2+ years of experience with medical terminology
• Intermediate proficiency with MS Office, including Excel and Word