Grievances and Appeals Coordinator

SCAN

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

Posted 9/23/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $20 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Grievances and Appeals, particularly in Intake for Part C and D Pre-Service Appeals, while providing exceptional customer service and maintaining accurate membership records. Capable of leading and mentoring a team, addressing complex issues, and suggesting service improvements based on member feedback.

Highest-signal resume keywords

Grievances And AppealsIntake For Part C And D Pre-Service AppealsCustomer Service SkillsAdvanced Microsoft Office SkillsLeadership And Mentoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievances And Appeals KnowledgeIntake ProcessMembership Database ManagementBasic Technical SkillsProblem-Solving Skills

Soft Skills

Good Communication SkillsInterpersonal SkillsAbility To Work Under Minimal Supervision

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft OutlookMicrosoft Teams

Industry Keywords

Member ServicesMember RetentionService OfferingsBackground Check

About the role

Key responsibilities & impact

Coordinate the work of a team of Member Services Representatives providing customer service to members and associated individuals and groups
Focus on intake for Part C and D Pre-Service Appeals
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
Prior experience with Intake for Part C and D Pre-Service Appeals is highly desired
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
Ability to provide 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
Basic problem-solving skills
Good communication and interpersonal skills
Advanced Microsoft Office skills (Word, Excel, PowerPoint, Outlook, Teams)
IKA, MHK, or QNXT experience preferred
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 and inclusive benefits
Opportunity to become part of a team that makes a difference to members and the community