Appeals Coordinator

A client of Innova Solutions is immediately hiring for an Appeals Coordinator

Position type : Full-time, Contract

Duration : 12 + Months

Location : Corona, CA 92881 (Hybrid)

As an Appeals Coordinator, you will :

• Manage the organization's complaint and grievance process, ensuring timely and thorough investigation of all cases.
• Collect and document relevant data for each case, including specialty or flagged cases, following appropriate protocols.
• Communicate effectively with internal and external stakeholders to ensure high-quality complaint resolution and enhance member experience.
• Collaborate with internal departments, managers, and physicians to resolve issues promptly.
• Research and resolve member complaints and grievances, and communicate decisions to members or their authorized representatives.
• Ensure all complaints and grievances are handled in compliance with applicable regulations, standards, and internal policies.
• Experience in a complex healthcare environment.
• Knowledge of federal and state healthcare regulations, laws, and accreditation standards.
• Familiarity with member complaint and grievance processes.

The ideal candidate will have : The ideal candidate will have will have experience in complaint and grievance handling, preferably within healthcare or call center environments, strong communication and conflict resolution skills, and the ability to manage sensitive cases with professionalism and compliance awareness.

Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.

We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.

Thank you!

SAURAV KUMAR

678-648-7393

Saurav.Kumar@innovasolutions.com

PAY RANGE AND BENEFITS :

Pay Range

Benefits : Innova Solutions offers benefits( based on eligibility) that include the following : Medical & pharmacy coverage, Dental / vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS : Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions :

Website :

Innova Solutions offers a referral bonus for qualified Ambassadors who refer eligible referrals. Submit referrals at and earn $250-$1,000 per referral.

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics / Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.

The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.