Grievance Customer Service Representative

A leading healthcare organization is seeking a dedicated and analytical Grievance Customer Service Representative to join our team. This position is 100% remote, with the understanding that you may be required to work onsite at our San Diego, Rio office during system outages or other operational needs. This is a 4-6 month contract with the potential for extension and the opportunity to apply for full-time employee positions.

In this role, you will be responsible for reviewing and resolving non-clinical member grievances. This is a crucial position that requires strong analytical and communication skills to ensure that member concerns are handled professionally and in a timely manner.

Location: Remote (Must reside within a 2-hour commute of the San Diego, Rio office located at 8954 Rio San Diego Dr, San Diego, CA 92108)

Compensation: $24.00/hr

Schedule: Monday - Friday, 8:00 AM - 5:00 PM

Key Skills and Qualifications

Required:

• 1-2 years of experience in a similar customer service, grievance, or claims-related field.
• Strong analytical skills with the ability to review and resolve complex issues.
• Excellent writing and communication skills for documenting grievances and corresponding with members.
• Proficiency in Microsoft 360 (Excel, Word).

Preferred:

• Experience with EPIC or Oracle .
• Familiarity with internal healthcare systems.
• Experience with financial or billing-related work.

Responsibilities

• Reviewing and investigating non-clinical member grievances.
• Documenting all grievance details and communication accurately.
• Working to resolve member issues efficiently and professionally.
• Collaborating with other departments as needed to address grievances.

If you are a detail-oriented professional with a passion for problem-solving and excellent customer service, we encourage you to apply!