Member Grievance & Appeals Specialist

Saferide Health, Inc.; United States; Remote; USD 42,000 - 56,000; Full time

Job summary

SafeRide Health is seeking an experienced Complaints and Grievance Coordinator responsible for processing complaints and grievances, including member grievances, appeals, and provider disputes. The role ensures cases are resolved according to client-specific requirements across all lines of business.

The position requires strong communication, organization, and problem-solving skills to manage timelines, respond to inquiries, and provide regular updates to leadership.

Qualifications

• High school diploma or equivalent required.
• At least 1 year in grievance and appeals processing.
• At least 1 year in an inbound call center environment.
• Preferred: experience with Medicaid, Medicare, and NEMT guidelines.
• Knowledge of health insurance programs and benefits.

Responsibilities

• Maintain contractual compliance and customer satisfaction.
• Ensure all assigned complaints and grievances are completed by the deadline and other contractual requirements.
• Respond to Comment Letters and client inquiries and requests.
• Ensure interactions remain positive and professional with all persons involved.
• Research the details and history of a case and create a clear timeline of events.
• Communicate with members and providers as needed.

Skills

Customer-focused

Problem-solving

Communication skills

Time management

Job description

SafeRide Health is seeking an experienced Complaints and Grievance Coordinator responsible for processing complaints and grievances, including member grievances, appeals, and provider disputes. The role ensures cases are resolved according to client-specific requirements across all lines of business.

The position requires strong communication, organization, and problem-solving skills to manage timelines, respond to inquiries, and provide regular updates to leadership.