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SCAN
SCAN
1,001 – 5,000 Employees
H1B Visa SponsorB2CHealthcareHealthcare Insurance
SCAN is a mission-driven healthcare organization dedicated to helping older adults live healthier, more independent lives. Founded in 1977, it combines healthcare insurance with evidence-based, patient-centered services, including in-home and virtual primary care, caregiver support, programs for homebound adults, and specialized care for vulnerable populations. SCAN also partners with and invests in organizations developing new care models and resources for aging at home.
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Grievances and Appeals Coordinator – Medicare Part C and D | SCAN

Coordinate Medicare Part C and D grievance resolution and support members and service teams at SCAN, a nonprofit health organization serving older adults.

USUnited StatesCACalifornia
$20 – $29 / hour
HybridFull-timeMiddleSeniorEnglish RequiredGeneral

Description

  • Lead Member Services Representatives who assist members and related individuals and groups.
  • Handle Medicare Part C and D grievances through resolution.
  • Respond to member inquiries and connect members with appropriate service providers.
  • Apply procedures to verify member identity, enrollment status, and eligibility for services.
  • Keep membership databases and records accurate and up to date.
  • Recommend service or program changes based on member feedback and coverage gaps.
  • Support member retention or renewal efforts as needed.
  • Advance SCAN’s vision and goals.
  • Carry out other assigned duties.

Requirements

  • 0–3 years of related experience handling grievances and appeals for a health plan, healthcare provider, or managed care organization.
  • Current or previous experience resolving Medicare Part C and D grievances is highly desirable.
  • High school diploma or equivalent experience required.
  • Comprehensive knowledge of grievance and appeals matters.
  • Customer service skills.
  • Ability to work with minimal supervision.
  • Ability to manage complex issues and refer only the most complex cases to higher-level staff.
  • Ability to lead, coach, or mentor a subordinate group; may serve as a lead or first-level supervisor.
  • Basic technical skills relevant to the role.
  • Advanced Microsoft Office skills, including Word, Excel, PowerPoint, Outlook, and Teams.
  • Experience with IKA, MHK, or QNXT preferred.
  • Basic problem-solving skills.
  • Strong communication and interpersonal skills.
  • Background check required.

Benefits

  • Annual employee bonus program.
  • Wellness program.
  • Generous paid time off.
  • Eleven paid holidays each year.
  • One floating holiday.
  • One birthday holiday.
  • 401(k) retirement savings plan with employer match and contribution.
  • Employee recognition program.
  • Tuition reimbursement.
  • Inclusive benefits.
  • Equal employment opportunity and affirmative action workplace.

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