Medicare Grievances & Appeals Team Lead

SCAN; Long Beach (CA); Hybrid; USD 28,000 - 40,000; Full time

Benefits offered by this job

Annual bonus

Wellness program

Paid time off

Holidays

401(k) retirement plan

Employee recognition

Tuition reimbursement

Job summary

SCAN is seeking a GAD Coordinator to coordinate a team delivering member services for Medicare Part C and D grievances. Responsibilities include ensuring enrollment verification, guiding inquiries to the right service providers, and maintaining member records.

The role emphasizes process improvement and potential involvement in member retention and renewal, with partial remote work and a strong emphasis on service excellence.

Qualifications

• 0–3 years of related experience in Grievances and Appeals for a health plan, healthcare, or managed care organization.
• Current or prior experience with Medicare Part C and D Grievances and closing out grievances is desirable.
• High school diploma or equivalent experience required.
• Comprehensive knowledge of grievances and appeals.

Responsibilities

• Coordinate the work of a team of Member Services Representatives.
• Handle Medicare Part C and D grievances and act as a closer.
• Verify member identity, membership status, and entitlement to services.
• Maintain current and accurate membership databases and records.
• Suggest new service offerings or revisions based on member feedback.
• Support member retention or renewal efforts.
• Support SCAN's Vision and Goals.
• Other duties as assigned.

Skills

Customer service

Communication

Problem solving

Leadership

Education

High school diploma or equivalent

Tools

Microsoft Office

IQMA

MHK

QNXT

Job description

SCAN is seeking a GAD Coordinator to coordinate a team delivering member services for Medicare Part C and D grievances. Responsibilities include ensuring enrollment verification, guiding inquiries to the right service providers, and maintaining member records.

The role emphasizes process improvement and potential involvement in member retention and renewal, with partial remote work and a strong emphasis on service excellence.