[Hiring] Grievances and Appeals Coordinator @SCAN Health Insurance

Role Description

The GAD Coordinator coordinates the work of a team of Member Services Representatives that provide customer services to members and other associated individuals and groups. This role will be focused on Intake for Part C and D Pre-Service Appeals.

Note: This position schedule will be Monday-Friday, 9am to 6pm Pacific Time.

• Ensure that member inquiries are addressed and that members are referred to the appropriate service provider(s).
• Administer policies and procedures for verifying member identity, membership status, and entitlement to services.
• Maintain current and accurate membership databases and records.
• Suggest new service offerings or revisions to existing programs based on member feedback or in response to member needs or gaps in coverage.
• May participate in member retention or renewal efforts.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Qualifications

• 0-3 years of related experience in Grievances and Appeals.
• Prior experience with Intake for Part C and D Pre-Service Appeals is highly desired.
• High school diploma or equivalent experience required.
• Possesses comprehensive knowledge of subject matter (grievance and appeals).
• Customer service skills.
• Performs work under minimal supervision.
• Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
• Provides leadership, coaching, and/or mentoring to a subordinate group. May act as a lead or first-level supervisor.
• Technical expertise - Basic technical skills for functional area.
• Problem Solving - Basic problem solving skills.
• Communication - Good communication and interpersonal skills.
• Advanced Microsoft Office Skills (Word, Excel, PowerPoint, Outlook, Teams). IKA, MHK, or QNXT experience preferred.

Benefits

• Base salary range: $20.14 to $29.16 per hour.
• Internal title: GAD Coordinator.
• Work Mode: Remote.
• An annual employee bonus program.
• Robust Wellness Program.
• Generous paid-time-off (PTO).
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday.
• Excellent 401(k) Retirement Saving Plan with employer match and contribution.
• Robust employee recognition program.
• Tuition reimbursement.
• An opportunity to become part of a team that makes a difference to our members and our community every day!

Company Description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.