Complaints and Grievance Coordinator (Healthcare)

Location: San Antonio, Texas, United States; hybrid

Company

hirify.global is a technology and services company improving access to non-emergency medical transportation through proprietary technology and a nationwide network of transportation providers for payers and health systems.

What you will do

• Process member complaints, grievances, appeals, and provider disputes according to client-specific requirements and contractual deadlines.
• Research case details and histories, create clear event timelines, and prepare complaint and grievance data.
• Communicate with members, providers, clients, and internal departments by phone, email, and in writing; provide updates on active cases.
• Respond to comment letters, client inquiries, requests, and escalations while maintaining positive and professional interactions.
• Provide daily, weekly, and monthly updates and provider trend data to leadership.
• Recommend corrective solutions and coordinate follow-up to prevent recurring problems.

Requirements

• High school diploma or equivalent.
• At least one year of experience processing grievances and appeals.
• At least one year of experience in an inbound call center environment.
• Customer-oriented approach and ability to follow company procedures while addressing customer needs.
• Strong problem-solving, analytical, listening, communication, documentation, summarization, and resolution skills.
• Ability to communicate, present, and influence effectively in person, by email, and over the phone.
• Ability to meet contractual reporting requirements and deadlines and adapt quickly to unforeseen circumstances.
• Ability to handle sensitive or complex issues tactfully and maintain effective relationships with members, coworkers, providers, and people from varying socioeconomic and cultural backgrounds, including special-needs populations.

Nice to have

• Experience with Medicaid, Medicare, and non-emergency medical transportation guidelines.
• Associate’s degree in a relevant discipline.
• Knowledge of health insurance programs and benefits.
• Leadership and mentoring skills.

Culture & Benefits

• Hybrid work in San Antonio, Texas.
• Work supports improved access to cost-effective, on-demand non-emergency medical transportation.
• Collaboration with members, providers, clients, leadership, and internal departments.