Grievance Resolution Specialist-730 at Roth Staffing Companies

Posted in Other about 4 hours ago.

Location: Orange, California





Job Description:

Minimum Qualifications:


- High School diploma or equivalent required.


- 1 year of experience in any of the following areas: Grievances and Appeals, Claims, Regulatory Compliance, Customer Service or related field required.


- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.


Preferred Qualifications:


- Associate's degree in business, health care administration or related field.


- Experience in health care practice standards for both government and commercial plans.


- Bilingual in English and in one of defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).


Required Licensure / Certifications:


- N/A


Knowledge & Abilities:


- Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.


- Work independently and exercise sound judgment.


- Communicate clearly and concisely, both orally and in writing.


- Work a flexible schedule; available to participate in evening and weekend events.


- Organize, be analytical, problem-solve and possess project management skills.


- Work in a fast-paced environment and in an efficient manner.


- Manage multiple projects and identify opportunities for internal and external collaboration.


- Motivate and lead multi-program teams and external committees/coalitions.


- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.


Physical Requirements (With or Without Accommodations):


- Ability to visually read information from computer screens, forms and other printed materials and information.


- Ability to speak (enunciate) clearly in conversation and general communication.


- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.


- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.


- Lifting and moving objects, patients and/or equipment 10 to 25 pounds


All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. To the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.


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