Complaints And Grievance Coordinator (Healthcare)

Location: Hybrid in San Antonio, Texas, United States

Company

Technology and services company improving access to non-emergency medical transportation through proprietary software and a nationwide network of transportation providers.

What you will do

• Process member complaints, grievances, appeals, and provider disputes in line with client-specific requirements.
• Research case histories, build timelines, prepare supporting data, and document resolutions.
• Communicate with members, providers, clients, and internal departments about active cases and required follow-up.
• Track deadlines, contractual requirements, escalations, and corrective actions.
• Provide regular complaint and grievance reports to leadership, including provider-related trends.
• Recommend solutions and coordinate measures to prevent recurring issues.

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.
• Strong written and verbal communication, documentation, analytical, listening, and problem-solving skills.
• Ability to manage contractual reporting requirements and deadlines and handle sensitive or complex issues tactfully.
• Ability to build effective relationships with members, coworkers, providers, and people from diverse 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 or mentoring experience.

Culture & Benefits

• Hybrid work arrangement in San Antonio.
• Work focused on reducing barriers to healthcare access and improving the patient experience.
• Cross-functional collaboration with member services, providers, clients, and internal leadership.