Program Assistant (Grievance & Appeals)

BuzzClan

Orange (CA)

On-site

USD 42,000 - 62,000

Full time

7 days ago
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Job summary

BuzzClan is seeking a detail-oriented Grievance & Appeals Specialist to manage intake, case documentation, and administrative support while ensuring compliance with healthcare program guidelines. You will receive, review, track, and route grievances and appeals, maintain accurate files, and coordinate with providers to gather supporting documents.

The role demands strong communication and the ability to handle confidential information.

Qualifications

  • High School Diploma or equivalent.
  • At least 1 year of experience with grievance and appeal guidelines, Medi-Cal/Medicaid, or Medicare programs.
  • Proficiency in Microsoft Office, including Word, Excel, Outlook, and PowerPoint.
  • Strong communication, organizational, and problem-solving skills.
  • Ability to manage multiple tasks, meet deadlines, and handle confidential information.

Responsibilities

  • Receive, review, track, and route grievances, appeals, and complaints.
  • Maintain accurate case files and update information in designated systems.
  • Gather supporting documents and coordinate with internal teams and providers.
  • Prepare acknowledgment letters and required correspondence.
  • Support regulatory requests and state hearing documentation.
  • Ensure timely processing and maintain confidential records.

Skills

Attention to detail
Communication
Multitasking
Grievance & Appeals knowledge

Education

High School Diploma or equivalent

Tools

Microsoft Office
Excel
Word
Outlook
PowerPoint

Job description

Job Title: Grievance & Appeals Specialist

Location: Onsite

Schedule: Monday–Friday, 8:00 AM–5:00 PM

Duration: Up to 6 Months

Job Summary

Seeking a detail-oriented Grievance & Appeals Specialist to manage complaint intake, case documentation, tracking, and administrative support while ensuring compliance with healthcare program guidelines.

Key Responsibilities

  • Receive, review, track, and route grievances, appeals, and complaints.
  • Maintain accurate case files and update information in designated systems.
  • Gather supporting documents and coordinate with internal teams and providers.
  • Prepare acknowledgment letters and required correspondence.
  • Support regulatory requests and state hearing documentation.
  • Ensure timely processing and maintain confidential records.

Required Qualifications

  • High School Diploma or equivalent.
  • At least 1 year of experience with grievance and appeal guidelines, Medi-Cal/Medicaid, or Medicare programs.
  • Proficiency in Microsoft Office, including Word, Excel, Outlook, and PowerPoint.
  • Strong communication, organizational, and problem-solving skills.
  • Ability to manage multiple tasks, meet deadlines, and handle confidential information.

Preferred Qualification

  • Bilingual in English and Arabic, Chinese, Farsi, Korean, Russian, Spanish, or Vietnamese.
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