Claims & Grievance Support Specialist

JOHNSON SERVICE GROUP; Orange (CA); On-site; USD 33,000 - 46,000; Full time

Benefits offered by this job

Weekly pay

Medical, dental, vision

Job summary

Johnson Service Group (JSG) is seeking a Customer Service/Claims Assistant for a Health Plan Partner. This on-site role in Orange County, CA offers a Mon-Friday 8am-4pm schedule with a pay range of $24-$33.50 per hour.

Primary duties include program support and handling grievances and appeals, plus administrative and documentation tasks. Ideal candidates will have a high school diploma or equivalent and at least 1 year of relevant experience, with bilingual capabilities in English and a

Qualifications

• High school diploma or equivalent plus 1 year of experience in appeal and grievance guidelines; Medi-Cal/Medicaid or Medicare programs experience preferred.
• Bilingual in English and one threshold language (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).

Responsibilities

• Assist the team with department responsibilities and support short- and long-term goals.
• Serve as the primary contact for inquiries related to grievances and appeals.
• Monitor complaints via the Customer Service system from members/providers and routes for resolution.
• Coordinate state and federal DMHC/Medicare/DMHC requests and document in the GARS system.

Skills

Customer service

Grievance handling

Communication

Education

High school diploma or equivalent

Job description

Johnson Service Group (JSG) is seeking a Customer Service/Claims Assistant for a Health Plan Partner. This on-site role in Orange County, CA offers a Mon-Friday 8am-4pm schedule with a pay range of $24-$33.50 per hour.

Primary duties include program support and handling grievances and appeals, plus administrative and documentation tasks. Ideal candidates will have a high school diploma or equivalent and at least 1 year of relevant experience, with bilingual capabilities in English and a