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JOB DETAILS

Appeals & Grievance Coordinator

CompanyAllCare Health
LocationGrants Pass
Work ModeOn Site
PostedNovember 10, 2026
About The Company
AllCare Health is an integrated health organization based in Southern Oregon with more than 250 employees. For 4 consecutive years, employees have voted AllCare Health a Top Workplace in the state of Oregon through The Oregonian’s annual survey. In a progressive model of care, AllCare Health combines medical, oral, and behavioral health services, along with Medicare Advantage, Medicare Supplement, and Oregon Health Plan (OHP) insurance coverage, and health information technology services in one organization. AllCare Health is led by Southern Oregon physicians, many of whom have been working together to serve Oregonians since 1994. For the more than 50,000 current members enrolled in various AllCare Health plans throughout the state, this means simpler, more efficient care delivered by a network of dedicated healthcare providers. As a Certified B Corporation, AllCare Health is dedicated to giving back to the community. We actively pursue and invest in the social determinants of health, including programs that support transitional and low-income housing, childhood nutrition, early childhood education, and improving access to healthcare. As a good neighbor, we understand that building a healthy community is about more than just doctor visits.
About the Role
 
Appeals & Grievance Coordinator at AllCare Health with the Quality department in Grants Pass, Oregon


We Are Seeking Qualified Candidates to Join Our Team!

AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.


Summary

This position is responsible for processing and resolving the Oregon Health Plan and Advantage Health Plan members and provider appeals and grievances by performing the following duties.

Essential Duties

  1. Investigates and resolves complex member and provider complaints related to enrollment and claims, provider payment disputes, medical appeals, and reversals within the health care industry.
  2. Provides the medical director with a complete case file for processing of the appeals and grievances and coordinates care or payment of services.
  3. Forwards appeals to CMS Independent Review Entity or to DMAP for further review.
  4. Collaborates with DMAP, CMS, or the independent review entity for review.


All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education.


Job Requirements

  • May require the use of personal vehicle for local travel (subject to mileage reimbursement).


Education & Experience

  • Associate's degree (AA) from a two-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience.


Certificates, Licenses and/or Registrations

  • Certified Professional Coder (CPC) is strongly preferred.


Physical Demands & Work Environment

The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl. The noise level in the work environment is usually moderate. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

  • The employee must be able to work on-site for all scheduled shifts.


Company Overview

AllCare Health Website:  https://www.allcarehealth.com.

AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp® status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at https://bcorporation.net/about-b-corps)

AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more.

 

The AllCare Health family of businesses is guided by our corporate principles:

Purpose | Working together with our communities to improve the health and well-being of everyone.

Values | Trust, Innovation, Relationships, and Voice.

Vision | Thriving, Inclusive, and Equitable communities.

Brand Promise | Changing Healthcare to Work for You.

 

AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others. 

If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call 541-471-4106 and ask for Human Resources.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.


Monday - Friday; 8:00am - 5:00pm w/ a 1 hour unpaid lunch & two 15 minute paid breaks
40 hours per week
Key Skills
Appeals ProcessingGrievance ResolutionComplaint InvestigationClaims ReviewProvider Payment DisputesMedical AppealsCase File PreparationCare CoordinationPayment CoordinationRegulatory CollaborationOregon Health PlanAdvantage Health PlanCMS Independent ReviewDMAP Coordination
Categories
HealthcareAdministrativeCustomer Service & Support
Benefits
Affordable Healthcare401k Retirement PlanWellness ProgramsFlexible Schedule OptionsMileage Reimbursement
Job Information
📋Core Responsibilities
Investigate and resolve complex member and provider appeals and grievances involving enrollment, claims, payment disputes, and medical decisions. Prepare complete case files for medical director review, coordinate care or payment, and work with CMS, DMAP, or independent review entities on further reviews.
📋Job Type
full time regular
💰Salary Range
$23 - $25
📊Experience Level
0-2
💼Company Size
297
📊Visa Sponsorship
No
💼Language
English
🏢Working Hours
40 hours
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