Grievance Coordinator

akidolabs; Ontario (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Akido Labs seeks a Grievance Coordinator to manage and resolve health plan grievances across clinics. You will collaborate with clinic leadership, operations, and health plans to investigate concerns, gather documentation, and prepare compliant responses, ensuring regulatory timelines are met.

The role requires strong investigative and writing abilities, healthcare operations knowledge, and the capacity to handle multiple deadlines in a fast-paced environment.

Qualifications

• High School Diploma or equivalent required.
• Minimum of one year in healthcare operations, patient relations, grievance management, quality, compliance, or health plan experience.

Responsibilities

• Manage the grievance process from receipt through resolution for all assigned health plans and clinics.
• Track and prioritize multiple grievance cases while ensuring turnaround times.
• Draft professional grievance responses and health plan communications.
• Maintain grievance logs, databases, and supporting documentation.
• Identify trends and opportunities for process improvement and member satisfaction.

Skills

Healthcare operations

Patient relations

Grievance management

Quality

Compliance

Health plans

Education

High School Diploma or equivalent

Job description

Akido builds AI-powered doctors . Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accurate, and more compassionate care.

Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties-from serving unhoused communities in Los Angeles to ride-share drivers in New York.

Founded in 2015 (YC W15), Akido is expanding its risk-bearing care models and scaling ScopeAI, its breakthrough clinical AI platform. Read more about Akido's $60M Series B . More info at Akidolabs.com .

Position Summary

The Grievance Coordinator is responsible for the management, investigation, documentation, and resolution of all health plan grievances, complaints, appeals support, and regulatory inquiries for clinics across the region. This role serves as the central point of contact for health plan grievance communications and ensures timely, accurate, and compliant responses in accordance with federal, state, health plan, and organizational requirements.

The Grievance Coordinator partners closely with clinic leadership, providers, operations teams, patient relations, quality, compliance, and health plans to investigate concerns, gather supporting documentation, identify root causes, and prepare comprehensive grievance responses. The position plays a critical role in maintaining regulatory compliance, improving patient satisfaction, identifying operational opportunities for improvement, and strengthening relationships with health plan partners.

The ideal candidate possesses strong investigative skills, exceptional written communication abilities, healthcare operations knowledge, and the ability to manage multiple deadlines in a fast-paced environment.

Essential Functions

• Serve as the primary coordinator for all health plan grievances, complaints, and member concerns received across the region.
• Receive, review, investigate, and respond to grievances within required regulatory and contractual timelines.
• Collaborate with clinic leaders, providers, departments, and operational teams to gather information needed for grievance investigations.
• Prepare clear, accurate, and professional written responses to health plans regarding member complaints and grievances.
• Review medical records, documentation, policies, procedures, and operational processes to support investigations.
• Ensure grievance responses meet health plan, CMS, state, delegated entity, and organizational requirements.
• Maintain detailed records of grievance investigations, findings, corrective actions, and resolutions.
• Monitor grievance deadlines and ensure timely submission of responses and supporting documentation.
• Identify trends, recurring issues, and operational concerns through grievance analysis.
• Escalate high-risk, regulatory, compliance, or quality concerns to leadership as appropriate.
• Coordinate with Patient Relations, Quality, Compliance, and Clinical Operations teams to implement corrective actions.
• Participate in audits and prepare documentation for health plan reviews and regulatory requests.
• Maintain confidentiality and compliance with HIPAA and privacy regulations.

Key Responsibilities

• Manage the grievance process from receipt through resolution for all assigned health plans and clinics.
• Track and prioritize multiple grievance cases while ensuring compliance with turnaround time requirements.
• Draft professional grievance response letters and health plan communications.
• Conduct routine follow-up with clinic leadership and stakeholders regarding open grievance investigations.
• Maintain grievance logs, databases, reporting tools, and supporting documentation.
• Ensure complete, accurate, and timely documentation of all grievance activities.
• Analyze grievance trends and identify opportunities for process improvement and member satisfaction enhancements.
• Assist leadership in developing corrective action plans related to grievance findings.
• Prepare recurring reports and dashboards related to grievance volume, timeliness, outcomes, and trends.
• Participate in health plan meetings and delegated oversight activities as assigned.
• Provide education and guidance to clinic staff regarding grievance management processes and best practices.
• Support patient experience initiatives by identifying barriers impacting member satisfaction.
• Collaborate with operational and clinical leaders to address systemic issues contributing to grievances.
• Maintain current knowledge of health plan requirements, regulatory updates, and industry best practices.

Required Qualifications

High School Diploma or equivalent required.

Minimum of one (1) year of healthcare operations, patient relations, grievance management, quality, compliance, or health plan experience.

Experience investigating and responding to patient compl