Grievances and Appeals Coordinator

SCAN

. Coordinate the work of a team of Member Services Representatives providing customer services to members and associated individuals and groups.

Posted 9/22/2026full-timeLong Beach • California • United StatesMid-LevelSenior💰 $20 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Medicare Part C and D Grievances, ensuring effective resolution and member satisfaction. Possesses strong customer service skills and the ability to lead and mentor a team while maintaining accurate membership records.

Highest-signal resume keywords

Medicare Part C GrievancesMedicare Part D GrievancesGrievance And Appeals KnowledgeCustomer Service SkillsLeadership And Mentoring

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Grievance ResolutionDatabase ManagementPolicy AdministrationProblem-Solving SkillsBasic Technical Skills

Soft Skills

Good Communication SkillsInterpersonal SkillsAbility To Work Under Minimal Supervision

Tools & Technologies

Microsoft OfficeWordExcelPowerPointOutlookTeamsIKAMHKQNXT

Industry Keywords

Managed Care OrganizationHealthcareMember ServicesMember RetentionMembership Status Verification

About the role

Key responsibilities & impact

Coordinate the work of a team of Member Services Representatives providing customer services to members and associated individuals and groups.
Focus on Medicare Part C and D Grievances as a grievance “closer.”
Ensure member inquiries are addressed and members are referred to appropriate service providers.
Administer policies and procedures for verifying member identity, membership status, and entitlement to services.
Maintain current and accurate membership databases and records.
Suggest new service offerings or revisions to existing programs based on member feedback or gaps in coverage.
May participate in member retention or renewal efforts.
Support SCAN’s Vision and Goals.
Perform other duties as assigned.

Requirements

What you’ll need

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 working on closing out grievances is highly desirable.
High school diploma or equivalent experience required.
Comprehensive knowledge of grievance and appeals.
Customer service skills.
Ability to perform work under minimal supervision.
Ability to handle complex issues and problems, referring only the most complex issues to higher-level staff.
Provides leadership, coaching, and/or mentoring to a subordinate group; may act as a lead or first-level supervisor.
Basic technical skills for the functional area.
Advanced Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) are required.
IKA, MHK, or QNXT preferred.
Basic problem-solving skills.
Good communication and interpersonal skills.
Background check required.

Benefits

Comp & perks

An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
Excellent 401(k) Retirement Saving Plan with employer match and contribution
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!