Complaints and Grievance Coordinator
saferidehealth · San Antonio
Job description
About the role
SafeRide Health is looking for a dedicated Complaints and Grievance Coordinator to manage member grievances, appeals, and provider disputes. The role ensures timely resolution of cases in line with contractual obligations and maintains high levels of customer satisfaction across all business lines.
Key responsibilities
- Maintain contractual compliance and meet all deadline requirements for assigned complaints and grievances.
- Respond to comment letters, client inquiries, and requests while keeping interactions professional.
- Research case histories, create clear timelines, and communicate updates to members and providers.
- Gather, review, sort, and prepare data related to complaints and grievances.
- Collaborate with internal departments to complete follow‑up research and resolve escalations.
- Provide daily, weekly, and monthly updates to leadership and recommend corrective actions.
- Analyze trends and supply leadership with data on provider complaint patterns.
Required profile
- High school diploma or equivalent.
- At least one year of experience in grievance and appeals processing.
- At least one year of experience in an inbound call‑center environment.
- Preferred experience with Medicaid, Medicare, and NEMT guidelines.
- Associate’s degree in a relevant discipline is a plus.
Required skills
- Customer‑oriented mindset with strong problem‑solving abilities.
- Excellent analytical and logical reasoning skills.
- Effective verbal and written communication, able to present and influence.
- Ability to meet reporting deadlines and adapt quickly to changing circumstances.
- Professionalism and tact when handling sensitive or complex issues.
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Published 2 weeks ago
Expires 1 month from now
12 views · 0 interested
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saferidehealth
San Antonio