Grievance Resolution & Complaints Specialist

SafeRide Health; San Antonio (TX); On-site; USD 52,000 - 78,000; Full time

Job summary

SafeRide Health is seeking an experienced Complaints and Grievance Coordinator to process member grievances, appeals, and provider disputes. This role ensures case resolution aligns with client-specific requirements across all lines of business.

The position emphasizes maintaining timely responses, data-driven updates to leadership, and cross-department collaboration to prevent recurrence of issues in a fast-paced environment.

Qualifications

• Minimum High school diploma or equivalent.
• Minimum one year in grievance and appeals processing.
• Minimum one year in an inbound call center environment.

Responsibilities

• Maintain contractual compliance and customer satisfaction.
• Ensure all assigned complaints and grievances are completed by deadlines.
• Respond to client inquiries and requests.
• Communicate professionally with members and providers.
• Research case details and timeline of events.
• Update members and providers on case progress.
• Prepare and review data related to complaints and grievances.
• Collaborate with departments to complete follow-up and research.
• Handle complaint and grievance escalations.
• Provide regular updates to leadership.
• Recommend corrective measures to prevent recurrences.
• Share provider complaint and grievance trends with leadership.
• Perform other duties as assigned.

Skills

Customer-focused

Problem-solving

Communication skills

Documentation

Time management

Education

High school diploma or equivalent

Associate’s degree (preferred)

Job description

SafeRide Health is seeking an experienced Complaints and Grievance Coordinator to process member grievances, appeals, and provider disputes. This role ensures case resolution aligns with client-specific requirements across all lines of business.

The position emphasizes maintaining timely responses, data-driven updates to leadership, and cross-department collaboration to prevent recurrence of issues in a fast-paced environment.