Position Summary
We are seeking a highly articulate and resilient Medicare Grievance & Resolution Specialist to join our team. The primary focus of this role is to handle customer grievances and complaints within a health insurance setting, ensuring all issues are addressed calmly, professionally, and in strict compliance with Medicare regulations. Because complaint volumes may fluctuate, the ideal candidate is highly adaptable and willing to jump in and assist with general administrative and operational tasks as needed.

Schedule

• Monday - Friday, 8:00 AM - 5:00 PM PST (40 work hours per week)

Key Responsibilities

• Grievance Management: Serve as the primary point of contact for patient and member complaints, addressing issues promptly and professionally.
• De-escalation: Confidently and calmly manage difficult conversations, successfully de-escalating upset or angry customers.
• Medicare Compliance: Assess, process, and respond to Medicare-related complaints in strict adherence to Medicare rules, regulations, and guidelines.
• Thorough Documentation: Accurately log, detail, and document all complaints and grievance interactions into the system to ensure comprehensive record-keeping.
• Administrative Support: Flexibly transition to taking on additional administrative or operational duties to support the wider team when complaint volumes are low.

Required Qualifications & Experience

• Speak fluent English to no accent and communicate very well
• Have experience working in a health plan/health insurance setting
• Have hands-on experience handling grievances and patient/member complaints
• Understand Medicare complaint requirements, rules, and regulations
• Know how to appropriately assess, document, and respond to Medicare-related complaints
• Be comfortable dealing with difficult or escalated situations
• Be detail-oriented and able to document complaints accurately and thoroughly
• Be flexible and willing to assist with other responsibilities when complaint volume is low

Independent Contractor Perks

• Permanent work from home
• Immediate hiring

Note

• Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

Important Disclaimer
BruntWork never charges fees for applying or any part of the hiring process—it is 100% free. If you are ever asked for payment, please stop and report it immediately to our official email us through the ‘Contact Us’ form on our official BruntWork website.