Grievances & Appeals Specialist (408388)

IDR is seeking a Grievances & Appeals Specialist (San Francisco) to join one of our top clients in the healthcare sector. This role is pivotal in addressing patient and family concerns, investigating complaints related to care quality, provider actions, and hospital policies. If you are looking for an opportunity to join a large organization and work within a team-oriented culture, please apply today!Position OverviewResponsibilities for the Grievances & Appeals Specialist (San Francisco):Investigate patient and family complaints regarding care quality, provider actions, and policy concernsHandle high-complexity cases requiring collaboration across departmentsWork with managers, physicians, and staff to resolve grievancesCoordinate with Legal and Risk Management on medical-legal mattersEnsure compliance with CMS Conditions of Participation and organizational grievance policiesRequired Skills for Grievances & Appeals Specialist (San Francisco):Bachelor's degree in Business Administration, Nursing, Social Work, or a related healthcare field (or equivalent experience)Minimum 2 years of recent experience in grievances, appeals, or patient advocacyStrong written and verbal communication for patient responses and case documentationAnalytical ability to conduct medical record reviews and quality-of-care investigationsProficiency in word processing, email, database management, and patient care softwareWhat's in it for you?Competitive compensation packageFull Benefits; Medical, Vision, Dental, and more!Opportunity to get in with an industry-leading organizationClose-knit and team-oriented cultureWhy IDR?25+ Years of Proven Industry Experience in 4 major marketsEmployee Stock Ownership ProgramMedical, Dental, Vision, and Life InsuranceClearlyRated's Best of Staffing® Client and Talent Award winner 11 years in a row

Created: 2025-02-21