Medicare Grievances & Appeals Coordinator

SCAN Health Insurance; Long Beach (CA); Hybrid; USD 41,000 - 60,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

Generous PTO

11 holidays + 1 floating + 1 birthday

Job summary

SCAN Health Insurance seeks a GAD Coordinator to lead a team delivering member services and resolving grievances, with a focus on Medicare Part C and D issues. You will ensure accurate records, verify eligibility, and drive process improvements.

The role emphasizes customer service, problem solving, and collaboration with cross-functional teams, with a path toward leadership responsibilities and potential for remote work.

Qualifications

• High school diploma or equivalent experience.
• Comprehensive knowledge of grievance and appeals.
• Experience with Medicare Part C and D grievances is highly desirable.
• Strong customer service and communication skills.

Responsibilities

• Coordinate a team of Member Services Representatives.
• Close out Medicare Part C and D grievances.
• Verify member identity, status, and entitlement to services.
• Maintain accurate membership databases and records.
• Suggest improvements based on member feedback.

Skills

MS Office

Advanced Excel

Communication

Problem Solving

Customer Service

Grievances & Appeals knowledge

Medicare Part C & D

Leadership

Education

High school diploma

Tools

IKA

MHK

QNXT

Job description

SCAN Health Insurance seeks a GAD Coordinator to lead a team delivering member services and resolving grievances, with a focus on Medicare Part C and D issues. You will ensure accurate records, verify eligibility, and drive process improvements.

The role emphasizes customer service, problem solving, and collaboration with cross-functional teams, with a path toward leadership responsibilities and potential for remote work.