22nd Century Technologies Inc. ยท 4 hours ago
Medicare Plans Coordinator (Grievance and Appeals)
Orange, CA
Contract
Onsite
Entry Level
$23/hr - $33/hr
1+ years exp22nd Century Technologies Inc. is seeking a Program Assistant (Grievance & Appeals) to support their mission-driven culture focused on high-quality performance and member service. The role involves managing grievances and appeals, monitoring complaints, and providing administrative support to ensure compliance with regulatory standards.
Artificial Intelligence (AI)Cloud ComputingEnterprise ApplicationsGovernmentInformation ServicesInformation TechnologyInfrastructureIT Infrastructure
Hiring Manager
Hardik Verma
Responsibilities
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department
Serves as the point of contact within or outside for inquiries related to grievances and appeals
Monitors incoming complaints via the Customer Service system routing, interdepartmental referral, mail, telephone, fax or via email from the website for members and providers
Monitors inquiry requests from the Department of Managed Health Care (DMHC), Medicare Complaint Tracking Module (CTM) from the Centers for Medicare Medicaid Services (CMS), Medicare Quality Improvement Organization (QIO) and the State Hearing Office from Department of Social Services (DSS)
Responds to DMHC requests for information in a timely manner
Sets up complaint case files, enters cases in the GARS system with accurate classification and category types and assigns them to appropriate staff
Works with internal and external departments and providers in gathering supporting information relevant to the case
Generates acknowledgment letters for all lines of business per department and regulatory standards
Assists in the development of departmental forms and intake processes
Coordinates administrative support for state hearings, serves as a contact with DSS for incoming cases, enters cases in the GARS system, creates electronic files and routes the scanned documents to designated staff and fax required state hearing documentation to the local hearing office as necessary
Completes other projects and duties as assigned
Qualification
Required
High School diploma or equivalent required
1 year of experience in appeal and grievance guidelines or Medi-Cal/Medicaid or Medicare programs required
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying
Bilingual in English and in one of defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese)
Company
22nd Century Technologies Inc.
22nd Century Technologies is an IT Systems Integrator, Software Products and Consulting Company
5001-10000 employees
H1B Sponsorship
22nd Century Technologies Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (19)
2023 (17)
2022 (22)
2021 (14)
2020 (21)
Funding
Current Stage
Late StageLeadership Team
Anil Sharma
Chief Executive Officer
Recent News
Company data provided by crunchbase