Supervisor Bilíngue ensuring efficient operational management processes and compliance at Allianz Partners. Managing costs, reports, and performance indicators with operational efficiency.
About the role
- Bilingual Complaints and Grievance Coordinator processing member grievances and appeals in a hybrid role at SafeRide Health. Ensuring contractual compliance and customer satisfaction with clear communication.
Responsibilities
- Maintain contractual compliance and customer satisfaction
- Ensure that 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 with whom you and the Complaints and Grievance Team interact in the course of your work, both internally and externally
- Researching the details and history of a case and creating a clear timeline of events
- Communicating, both orally and in writing, with members and providers as needed
- Updating members and providers regarding the progress of active and open cases
- Requesting, reviewing, sorting, and preparing data related to complaints and grievances
- Working with relevant departments to complete all necessary follow-up and research
- Complaint and grievance escalations
- Interdepartmental and Client Communication
- Provide daily, weekly and monthly complaint and grievance updates to leadership
- Recommend solutions and work with internal department leadership to ensure problems are corrected, and departments are advised of corrective measures to prevent recurrences
- Provide complaint and grievance data to leadership regarding provider complaint and grievance trends
- Other duties as assigned
Requirements
- Minimum High school diploma or equivalent
- Minimum one (1) year in grievance and appeals processing
- Minimum one (1) year in an inbound call center environment
- Experience with Medicaid, Medicare, and NEMT guidelines
- Associate’s degree in relevant discipline
- Knowledge of health insurance programs and benefits
- Bilingual (Spanish)
Benefits
- N/A
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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