Appeals & Grievances Specialist I

Employment Type: Contract

Pay Range: $26.56-$33.20 Per HRDescriptionJoin our team as an Appeals & Grievances Specialist I in Los Angeles, CA.This onsite contract role requires expertise in managed care, specifically with Medicare and Medi-Cal. The position demands excellent communication skills and the ability to manage cases within strict regulatory deadlines, working Monday through Friday with every Saturday required.

Requirements: Minimum 1 year of managed care experience with Medicare, Medi-Cal, and state-sponsored programs. Direct experience in appeals and grievances. Ability to write resolution letters effectively. Strong knowledge of Medicare and Medi-Cal regulations. Proven case management skills with adherence to deadlines. Excellent written communication and organizational skills. High school diploma or GED.

Qualifications: Associate's degree preferred. In-depth knowledge of CMS, DHCS, DMHC, and NCQA regulations. Experience with medical terminology and member advocacy. Contact Authorization: By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here https://www.mitchellmartin.com/privacy-policyBenefits:Learn more about our benefits offerings here https://www.mitchellmartin.com/careers/benefits-perksOnboarding Expectations: Learn more about our Onboarding Process here https://youtu.be/rjV_NFYjyY4EEO Statement: Learn more about our EEO policy here https://www.mitchellmartin.com/eoe-statement#LI-MS3