Non-Clinical - Administrative / Quality Assurance Analyst

Grievances And Appeals Specialist

The Grievances & Appeals Specialist plays a critical role in supporting patients and families by investigating complaints, concerns, and feedback received by the organization. The responsibilities include : Investigating patient / family complaints related to care quality, physician / provider actions, Sutter Health policies, and potential liability. Handling appeals for denied claims or services, ensuring all processes are followed, and providing clear communication to patients and families regarding the outcomes of their appeals.