Regulatory Complaint Coordinator, Specialist

Your Role

The Appeals and Grievances Commercial Regulatory team is responsible for responding to inquiries received directly from our state regulatory agencies. The Regulatory Complaint Coordinator, Specialist will report to the Supervisor of Appeals and Grievances. In this role you will be responsible for oversight of team reviewing, researching, and responding to complex regulatory appeals and grievance cases within established compliance timeframes.

Your Knowledge and Experience

• Requires a high school diploma or GED
• Requires at least 7 years of experience
• Requires at least 6 years in health insurance operations such as I&M, Claims, Customer Services, Regulatory Affairs and/or Appeals/Grievances, at least 2 years of which is Appeals/grievance direct experience, or similar combination
• Regulatory Appeals and Grievances experience preferred
• Experience reading regulation, senate bills, and all plan letters (APL) preferred
• Knowledge of Microsoft Office, specifically, Word and Excel (must be able to enter and manipulate data)
• Willing to work weekends and/or holidays depending on business needs

Pay Range:

The pay range for this role is: $ 27.24 to $ 38.13 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.