Oscar Health is hiring a CGA Triage Coordinator to play a critical role in our member support operations. You will be responsible for the timely and accurate initial management and routing of all member complaints, grievances, and appeals.
What You'll Do
- Receive, log, and process all incoming complaints, grievances, and appeals through various channels, including mail, fax, email, and internal systems.
- Monitor and manage case queues, proactively flagging urgent cases and assigning them to the appropriate liaison or team.
- Identify, investigate, and triage incoming documents within determined SLAs.
- Collaborate with colleagues, specialists, and Leads to identify trends and roadblocks.
- Utilize internal tools and resources seamlessly.
- Escalate updates or incorrect information in the internal knowledge management system for Member and Provider Services.
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
What We're Looking For
- 1+ years of customer support or service experience.
- Excellent organizational and time management skills.
- Foundational knowledge of escalations or complaints, grievances and appeals processes.
Nice to Have
- Experience in a Complaints, Grievances or Appeals department.
- Experience using CRM and knowledge management tools to resolve issues.
- Experience using ticket management and reporting tools.
- Experience managing an assignment caseload.
- Healthcare and/or SAAS experience.
Technical Stack
- CRM and knowledge management tools
- Ticket management and reporting tools
Team & Environment
You will report into the CGA Team Lead.
Benefits & Compensation
- Compensation: $22.00 per hour
- Medical, dental, and vision benefits
- 11 paid holidays
- Paid sick time
- Paid parental leave
- 401(k) plan participation
- Life and disability insurance
- Paid wellness time and reimbursements
- Monthly vacation accrual at a rate of 15 days per year
Work Mode
This is a remote position open to candidates located in Arizona, Florida, Georgia, or Texas.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices.
