Program Assistant; Grievance & Appeals

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.