Program Assistant (Grievance & Appeals)

Kinetic Personnel GroupOrange, CA
426d$48,880 - $68,640

About The Position

The Program Assistant for Grievance & Appeals at Kinetic Personnel Group Inc. will support the Grievance and Appeals Resolution Services (GARS) department within a Public Health Plan. This role involves monitoring and processing appeals and grievances, serving as a point of contact for inquiries, and assisting in administrative tasks related to the department's operations. The position is temporary with the potential for permanent placement after six months, requiring in-office work from Monday to Friday.

Requirements

  • High school diploma or GED required.
  • 1 year of experience in appeal and grievance guidelines or Medi-Cal/Medicaid or Medicare programs required.

Nice To Haves

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

Responsibilities

  • Monitor the GARS member and provider mailbox, fax, mail, and process appeals and grievances for assignment to key staff.
  • Participate in a mission-driven culture focused on high-quality performance and customer service.
  • Serve as the point of contact for inquiries related to grievances and appeals.
  • Monitor incoming complaints via various channels including Customer Service system, mail, and email.
  • Respond to requests for information from the Department of Managed Health Care (DMHC) in a timely manner.
  • Set up complaint case files and enter cases in the GARS system with accurate classification and category types.
  • Assist in the development of departmental forms and intake processes.
  • Coordinate administrative support for state hearings and manage documentation.

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • 401(k)

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Industry

Administrative and Support Services

Education Level

High school or GED

Number of Employees

1-10 employees

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