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 10/14/2026full-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 customer service and member support. Capable of maintaining accurate membership records and providing leadership and mentoring within a team environment.

Highest-signal resume keywords

Medicare Part C GrievancesMedicare Part D GrievancesGrievances And Appeals KnowledgeAdvanced Microsoft OfficeCustomer Service Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievances And Appeals ManagementMembership Database MaintenancePolicy AdministrationProblem-Solving SkillsBasic Technical Skills

Soft Skills

Communication SkillsInterpersonal SkillsLeadershipCoachingMentoring

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft OutlookMicrosoft TeamsIKAMHKQNXT

Industry Keywords

HealthcareManaged CareMember ServicesCustomer ServiceMember Retention

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 "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 coverage gaps
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 subject matter
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) 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
1 floating holiday
1 birthday holiday
Excellent 401(k) Retirement Saving Plan with employer match and contribution
Robust employee recognition program
Tuition reimbursement
Inclusive benefits
Equal Employment Opportunity and Affirmative Action workplace