New

Grievance & Appeals Coordinator I - 210056

TEKsystems
$23.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Los Angeles
Jun 09, 2026
Description Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Education/Experience: High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills. * Gather, analyze and report verbal and written member and provider complaints, grievances and appeals * Prepare response letters for member and provider complaints, grievances and appeals * Maintain files on individual appeals and grievances * May coordinate the Grievance and Appeals Committee * Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information * Assist with HEDIS production functions including data entry, calls to provider's offices, and claims research. * Manage large volumes of documents including copying, faxing and scanning incoming mail Additional Skills & Qualifications Additional qualities to look for: Must haves: * 2-3 years of experience in a similar role, preferably within appeals and grievances, healthcare administration, or customer service in a regulated environment. researching skills Experience working with complex cases or compliance-related tasks is highly desirable. Nice to haves: * Knowledge of Healthcare Regulations - Understanding of health plan compliance, regulatory requirements, or experience with Medicare/Medicaid guidelines. * Conflict Resolution Skills - Ability to handle sensitive cases with professionalism and empathy. * Project Coordination Experience - Exposure to coordinating cross-functional projects or initiatives in a fast-paced environment. * Good Letter writing skills Disqualifiers: Job hopping - Please state if the previous position was contract and if completed. Looking for individuals to move forward with conversion and serious about the role. * Lack of Experience in Appeals/Grievances or Regulated Environments - Candidates without relevant experience in healthcare, insurance, or similar regulatory fields may not be suitable. * Poor Attention to Detail - Inaccuracies or errors in case handling can impact quality standards. * Inadequate Communication Skills - The role requires clear and effective communication with team members and stakeholders. * Lack of Problem-Solving Skills - Inability to contribute to continuous improvement or resolve complex cases collaboratively. Performance indicators: * Accuracy and Quality Compliance - Consistently meets or exceeds the 97% quality standard with minimal errors. * Efficiency and Productivity - Completes case reviews and resolutions ahead of deadlines while maintaining high standards. * Effective Collaboration and Communication - Proactively collaborates with the management team and cross-functional departments, contributing to positive team dynamics and problem-solving. * Customer Satisfaction and Resolution - Resolves member grievances effectively, Experience Level Entry Level Job Type & LocationThis is a Contract position based out of Los Angeles, CA. Pay and BenefitsThe pay range for this position is $23.00 - $23.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace TypeThis is a fully remote position. Application DeadlineThis position is anticipated to close on Jun 15, 2026. About TEKsystems We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.