Grievance and Appeals Coordinator (Healthcare) – $23/hr (Onsite)
Location: Woodland Hills, CA 91367
Schedule: Monday–Friday, standard business hours
Pay: $23.00 per hour
Summary
Hiring a detail-driven Grievance and Appeals Coordinator to support a high-volume healthcare operations team. This Grievance and Appeals Coordinator position focuses on coordinating member grievances and appeals from intake through resolution—tracking deadlines, maintaining audit-ready documentation, and communicating status updates clearly and professionally. If you have experience in managed care, health plan operations, member services, claims support, or medical office/clinic administration and you’re comfortable working in fast-paced work queues, this is a strong opportunity to grow in healthcare administration and compliance.
Responsibilities
- Coordinate the end-to-end grievance and appeals process for members
- Review incoming cases for completeness and route/escalate appropriately
- Track due dates, regulatory timeframes, and required correspondence to ensure on-time responses
- Communicate with members regarding case status, documentation needs, and next steps (phone, written, and system-based updates)
- Maintain accurate case notes and documentation for compliance and audit readiness (HIPAA/PHI environment)
- Collaborate with internal departments to resolve issues (claims, clinical teams, provider services, customer service, operations)
- Monitor outcomes and identify common issues, documentation gaps, or process trends
- Maintain professionalism, confidentiality, and consistent quality in a deadline-driven workflow
Qualifications
- Healthcare experience required (health plan, managed care, hospital, clinic, revenue cycle, or call center healthcare support)
- Experience with grievances and appeals, member services, claims, prior authorization, utilization management support, or case management support preferred
- Strong written communication skills for member-facing updates and documentation
- Strong attention to detail and ability to manage multiple cases with competing deadlines
- Comfortable navigating multiple systems (case tracking tools, work queues, spreadsheets, payer/provider portals)
- Professional phone presence and customer service mindset
- High school diploma or GED required; additional healthcare/business education is a plus
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