• Review, research, and process member appeals and grievances in compliance with regulatory guidelines and company policies.
• Analyze case documentation, identify issues, and ensure timely resolution within established turnaround times.
• Communicate effectively with members, providers, and internal teams to gather necessary information and provide status updates.
• Maintain accurate records and documentation for audits and reporting requirements.
• Collaborate with cross-functional teams to improve processes and enhance member satisfaction.

• Previous experience in healthcare appeals, grievances, or claims processing preferred.
• Strong knowledge of regulatory requirements (CMS, state guidelines) is a plus.
• Excellent attention to detail, organizational skills, and ability to manage multiple priorities.
• Proficient in Microsoft Office and comfortable working with case management systems.
• Strong written and verbal communication skills.

• Competitive hourly pay: $22–$25
• Opportunity to transition to a permanent role with a respected healthcare organization.
• Work in a collaborative environment that values accuracy, compliance, and member advocacy.

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www-uat.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: 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.