Grievance Coordinator

Lumeris

. Conduct thorough investigations into member complaints and identify all issues or components of each grievance .

Posted 10/23/2026full-timeRemote • United StatesJunior💰 $44,100 - $54,825 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong investigatory skills and critical thinking to effectively resolve member grievances while maintaining high ethical standards. Capable of managing multiple cases in a high-volume environment and communicating effectively with diverse stakeholders.

Highest-signal resume keywords

Grievance ResolutionRoot Cause AnalysisInvestigatory SkillsOrganizational SkillsCustomer Service

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementRisk AssessmentComplaint Process KnowledgeDocumentationData Gathering

Soft Skills

Critical ThinkingProblem-SolvingInterpersonal SkillsCommunicationMulti-Tasking

Certifications & Qualifications

Bachelor's DegreeCOVID-19 Vaccination

Industry Keywords

Member ComplaintsHigh-Volume EnvironmentEthical StandardsMember-Facing PositionCollaboration

About the role

Key responsibilities & impact

Conduct thorough investigations into member complaints and identify all issues or components of each grievance
Achieve grievance resolution through action and education for members
Conduct root cause analysis on escalated member grievances to identify underlying system, plan, or provider issues
Research, gather information and evidence, and conduct timely outreach with members, providers, and internal and external partners
Review issues and assess appropriate resolution
Document investigations as accurate and complete chronological records of actions, communications, information obtained, member resolution, and notification
Ensure grievance resolutions reflect and fully address members' complaints
Manage several cases simultaneously in a high-volume, high-touch environment
Build rapport and collaborate across the organization
Recognize urgent and sensitive issues and escalate them promptly
Communicate assignment status in weekly internal meetings
Apply knowledge of complaints and plan processes to articulate issues and resolutions

Requirements

What you’ll need

Bachelors degree or equivalent
1+ years of related work experience or the knowledge, skills, and abilities to succeed in the role
Authorized to work in the United States; visa sponsorship is unavailable
Ability to maintain high ethical standards
Good critical thinking and problem-solving skills
Ability to multi-task and operate effectively in both remote and in-person settings
Good investigatory skills with ability to organize, review, and effectively assess risk and appropriate response
Ability to remain fair and identify facts
Organizational skills for prioritizing tasks to meet set deadlines
Good communication and interpersonal skills with the ability to interact at all levels
Good customer service skills
Member-facing position
Initial series of an approved COVID-19 vaccine required for personnel interacting with at-risk members or prospects

Benefits

Comp & perks

Medical, Vision and Dental Plans
Tax-Advantage Savings Accounts (FSA & HSA)
Life Insurance and Disability Insurance
Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
Employee Assistance Program
401k with company match
Employee Resource Groups
Employee Discount Program
Learning and Development Opportunities
Performance-based incentive and/or equity may be available depending on the position
Approved COVID-19 vaccination coverage/requirement for member-facing personnel