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 Medicare Advantage Part C and D Post-Service Appeals, with strong customer service and problem-solving skills. Capable of leading and mentoring a team while maintaining accurate membership records and databases.

Highest-signal resume keywords

Medicare Advantage Part C And D Post-Service AppealsGrievances And Appeals KnowledgeCustomer Service SkillsAdvanced Microsoft OfficeLeadership And Mentoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievances And Appeals KnowledgeMedicare Advantage Part C And D Post-Service AppealsBasic Technical SkillsProblem-Solving Skills

Soft Skills

Customer Service SkillsGood Communication SkillsInterpersonal Skills

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft OutlookMicrosoft TeamsIKAMHKQNXT

Industry Keywords

Health PlanHealthcareManaged Care Organization

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 Advantage Part C and D Post-Service Appeals
Ensure member inquiries are addressed and refer members 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
Prior experience with Medicare Advantage Part C and D Post-Service Appeals is highly desired
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) 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
Equal pay, employee resource groups, inclusive benefits, and more