Aroha Technologies, Inc
Grievance Resolution Specialist (Provider Resolution) Healthcare
Aroha Technologies, Inc, Orange, California, United States, 92613
Grievance Resolution Specialist (Provider Resolution) Healthcare
We are currently seeking a
Temporary Grievance Resolution Specialist (Provider Resolution)
to join our team and support our mission of delivering high-quality, member-focused healthcare services. This position plays a key role in coordinating the
Grievance and Appeals resolution process , responding to verbal and written inquiries from both members and providers related to eligibility, benefits, contract administration, claims, pharmacy, vision, and utilization management decisions.
Position Details
Job Title: Temporary – Grievance Resolution Specialist (Provider Resolution)
Department: GA – Provider Disputes
Pay Range: $25/HR - $30/HR
Schedule: Monday – Friday | 8:00 AM – 5:00 PM
Location: Orange, CA 92868
Duration: Temporary Assignment for 6 months
Key Responsibilities
Investigate and resolve provider grievances and appeals
Collaborate with internal teams (Customer Service, Provider Relations, Pharmacy, Medical Management)
Review contracts, DOFRs, and policies to assess case details
Draft provider/member resolution letters and document case outcomes
Maintain accurate records in CalOptima Health’s systems
Ensure regulatory compliance and timely resolution
Minimum Qualifications
High school diploma or equivalent
1+ year of experience in Medicare/Medi-Cal provider appeals and denials
Experience in Grievances and Appeals, Claims, Compliance, or related areas
Strong communication, organizational, and case management skills
Preferred Qualifications
Associate degree in healthcare administration or related field
Bilingual in one of CalOptima’s threshold languages (e.g., Spanish, Vietnamese, Korean)
Familiarity with provider dispute resolution and regulatory standards
If you're looking to make an impact in healthcare and bring resolution to complex provider issues in a dynamic and supportive environment, we’d love to hear from you.
Please let me know if you're interested, and I will be happy to provide additional information on how to apply.
Best regards, Ayushi kaushik Healthcare Recruiter Direct: 510.660.6056 Email: ayushi@arohatechnologies.com 5000 Hopyard RD, Suite 415 Pleasanton, CA 94568 https://www.arohatechnologies.com
#J-18808-Ljbffr
Temporary Grievance Resolution Specialist (Provider Resolution)
to join our team and support our mission of delivering high-quality, member-focused healthcare services. This position plays a key role in coordinating the
Grievance and Appeals resolution process , responding to verbal and written inquiries from both members and providers related to eligibility, benefits, contract administration, claims, pharmacy, vision, and utilization management decisions.
Position Details
Job Title: Temporary – Grievance Resolution Specialist (Provider Resolution)
Department: GA – Provider Disputes
Pay Range: $25/HR - $30/HR
Schedule: Monday – Friday | 8:00 AM – 5:00 PM
Location: Orange, CA 92868
Duration: Temporary Assignment for 6 months
Key Responsibilities
Investigate and resolve provider grievances and appeals
Collaborate with internal teams (Customer Service, Provider Relations, Pharmacy, Medical Management)
Review contracts, DOFRs, and policies to assess case details
Draft provider/member resolution letters and document case outcomes
Maintain accurate records in CalOptima Health’s systems
Ensure regulatory compliance and timely resolution
Minimum Qualifications
High school diploma or equivalent
1+ year of experience in Medicare/Medi-Cal provider appeals and denials
Experience in Grievances and Appeals, Claims, Compliance, or related areas
Strong communication, organizational, and case management skills
Preferred Qualifications
Associate degree in healthcare administration or related field
Bilingual in one of CalOptima’s threshold languages (e.g., Spanish, Vietnamese, Korean)
Familiarity with provider dispute resolution and regulatory standards
If you're looking to make an impact in healthcare and bring resolution to complex provider issues in a dynamic and supportive environment, we’d love to hear from you.
Please let me know if you're interested, and I will be happy to provide additional information on how to apply.
Best regards, Ayushi kaushik Healthcare Recruiter Direct: 510.660.6056 Email: ayushi@arohatechnologies.com 5000 Hopyard RD, Suite 415 Pleasanton, CA 94568 https://www.arohatechnologies.com
#J-18808-Ljbffr