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Grievances and Appeals Coordinator
SCANGAD Coordinator managing a team providing customer services to SCAN members. Ensuring effective communication and support for member inquiries and service provision.
About the role
Key responsibilities & impact- Ensure that member inquiries are addressed and that members are referred to the appropriate service provider(s)
- 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 in response to member needs or gaps in coverage
- May participate in member retention or renewal efforts
- Actively support the achievement of SCAN’s Vision and Goals
- Other duties as assigned
Requirements
What you’ll need- 0-3 years of related experience in Grievances and Appeals
- High school diploma or equivalent experience required
- Possesses comprehensive knowledge of subject matter (grievance and appeals)
- Customer service skills
- Performs work under minimal supervision
- Handles complex issues and problems, and refers 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
- Technical expertise - Basic technical skills for functional area
- Problem Solving - Basic problem solving skills
- Communication - Good communication and interpersonal skills
- Advanced Microsoft Office Skills (Word, Excel, PowerPoint, Outlook, Teams)
- IKA, MHK, or QNXT experience preferred.
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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Grievances And AppealsMembership Database ManagementPolicy AdministrationTechnical ExpertiseProblem Solving
Soft Skills
Communication SkillsInterpersonal Skills