6 Results for Grievance And Appeals Specialist Jobs in San Bernardino, CA

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Grievance and Appeals Specialist

San Bernardino, CA
onsite
Temporary to Hire
25.01 - 35.67 USD / Hourly
A Medical Claims Organizations is in the immediate need of Grievance and Appeals Specialist with experience in grievances and appeals to join the team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Grievance and Appeals Specialist candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations. Key Responsibilities: <ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as neededGrievance and Appeals Specialist</li></ul>
2026-09-25T00:00:00Z

Benefits Specialist

Irvine, CA
onsite
Temporary to Hire
34.257 - 39.666 USD / Hourly
We are looking for a Benefits Specialist to join a team in Irvine, California in a Contract to Permanent role. This position supports the delivery of employee benefits programs by helping with enrollments, employee inquiries, records management, and benefits system activity. The ideal candidate brings strong attention to detail, a service-oriented approach, and the ability to manage several priorities while contributing to a positive employee experience. Responsibilities: • Provide day-to-day support for health, retirement, life, disability, and voluntary benefit programs while ensuring employees receive accurate and timely assistance. • Investigate and resolve issues related to enrollments, eligibility, carrier connections, billing questions, and claims concerns. • Guide employees through benefits processes and help them use benefits administration tools effectively. • Process benefits-related events such as employee enrollments, life status changes, and open enrollment activities while monitoring deadlines and documentation requirements. • Partner with HR teams and internal stakeholders to verify data accuracy, reconcile records, and address discrepancies with carriers or system files. • Assist with audits, testing, troubleshooting, and ongoing maintenance for HRIS and benefits administration platforms, including support for system updates or implementations when needed. • Coordinate assigned benefits projects by tracking milestones, organizing communications, maintaining documentation, and following through on action items. • Contribute to process improvements, employee communications, wellness initiatives, and compliance reporting to strengthen consistency and engagement across the organization.
2026-09-18T00:00:00Z

Benefits Specialist

Brea, CA
onsite
Temporary / Contract
32 - 36 USD / Hourly
We are looking for someone with 2–4 years of hands-on employee benefits and/or HR experience who can jump in and support the Benefits Manager across a portfolio of approximately 23 brands.The ideal candidate will have experience with:• Medical, dental, vision, life, disability, 401(k), and voluntary benefits • New hire enrollment and qualifying life events • Open enrollment and benefits administration • Employee questions and benefits issue resolution • Eligibility, carrier, billing, claims, and enrollment discrepancies • HRIS and/or benefits administration systems • Benefits reporting, audits, and data reconciliation • Basic ACA compliance knowledge • Excel and Microsoft Office • Managing multiple projects, deadlines, and follow-ups • Working with HR, payroll, carriers, vendors, and employees
2026-09-18T00:00:00Z

Litigation Attorney

Irvine, CA
remote
Permanent / Full Time
150000 - 185000 USD / Yearly
A well‑established business and real estate law firm is seeking a Litigation Attorney with a minimum of 3 years of California civil litigation experience to join its growing team. This firm offers a genuinely supportive and collaborative culture, a clear path to partnership, and a strong emphasis on work‑life balance. Attorneys are encouraged to pursue professional development and engage in outside activities that matter to them. The firm is very flexible, and this Litigation Attorney will work 100% remotely! Responsibilities<ul><li>Client communication</li><li>Discovery</li><li>Drafting law and motion</li><li>Attending court appearances</li><li>Taking and defending depositions</li><li>Assisting with trial preparation</li><li>Annual billable requirement: 1750 hours</li></ul> The firm offers a competitive compensation package, including bonus potential and a comprehensive benefits suite: medical, dental, and vision insurance; 401(k); PTO, sick time, paid holidays; paid bar dues and MCLE credits; and more! For immediate consideration for this attorney opportunity, please send your resume directly to Assistant Vice President of Direct Hire, Tess Poliakin: Tess.Poliakin<at>RobertHalf.<com>
2026-09-18T00:00:00Z

Litigation Attorney

Irvine, CA
onsite
Permanent / Full Time
120000 - 150000 USD / Yearly
High-end boutique law firm located in Irvine; CA has an immediate opportunity for a litigation attorney to join their team. This firm is offering the litigation attorney mentorship and development as well as the opportunity to work on complex litigation matters related to commercial litigation, employment law and real estate. Responsibilities: • Handle employment and business litigation cases• Utilize case management software and legal software such as LexisNexis for efficient management of cases• Employ strong litigation skills with a minimum of 5 years of experience• Demonstrate significant state and federal court experience• Show familiarity with class action procedural rules and ESI discovery• Handle PAGA cases and A-Z class action employment • Conduct depositions and manage law & motion • Apply trial experience in handling cases• Use management systems for efficient workflow• Conduct briefings and present complex legal information in an understandable manner. To apply, submit resumes to Vice President, Quidana Dove at Quidana.Dove <at> RobertHalf. <com> #SoCalRHL
2026-09-25T00:00:00Z

Litigation Attorney

Laguna Hills, CA
onsite
Temporary to Hire
79.1635 - 91.663 USD / Hourly
We are looking for an experienced Litigation Attorney to join a growing legal practice in Laguna Hills, California on a contract-to-permanent basis. This opportunity is well suited for a California-licensed attorney who is comfortable leading matters independently and guiding cases from initial filing through final resolution. The position offers meaningful ownership of a civil litigation docket, with strong consideration for candidates who bring recent construction litigation experience. Attorneys with substantial relevant experience may also be considered for flexible remote work arrangements. Responsibilities: • Oversee a portfolio of active litigation files and move each matter forward with limited day-to-day supervision. • Direct cases through every stage of the litigation process, from early case assessment and pleadings to settlement or trial preparation. • Prepare, file, and argue motions while developing persuasive written submissions that support case strategy. • Perform thorough legal analysis and produce well-crafted pleadings, briefs, and other court-ready documents. • Lead discovery efforts, including written discovery, document review, depositions, and related case development activities. • Advise clients on risk, strategy, and potential outcomes throughout the life of each matter. • Participate in settlement discussions and negotiate resolutions aligned with client objectives. • Work closely with firm leadership on case strategy while independently managing daily litigation responsibilities.
2026-09-11T00:00:00Z

6 results for Grievance And Appeals Specialist in San Bernardino, CA