Complaints Coordinator

Company: Pride Health
Location: Amherst
Posted on: March 17, 2026

Job Description:

Job Description Job title : Complaints Coordinator Job location : New York, NY 10004 Shift : Hybrid 9-5 Date Range: 03/30/2026 - 05/23/2026, Possible Extension Pay : $19- $21/hr without benefits Education: High School Diploma/ GED Skills: Assist Complaints Team leader with MACESS documentation inquiries/complaints . Assist specialists with escalated issues (transportation requests, specialty appointments). Support management with special projects (PCP monthly projects, MIS assignments, PCP error reports). Record and respond to customer contacts and update the tracking system with follow-up and closure. Provide member orientations (on-site and telephone). Process and resolve complaints and update information in the system. Assist with PCP selection/assignment and member demographic updates . Provide benefit/service information to members, prospective members, and providers. Perform retention efforts , handle Medicare overflow calls , and support outreach projects . Handle roster, disenrollment, provider, and claim billing inquiries . Schedule marketing appointments for prospective enrollees. Skills: Customer Focus, Functional/Technical Skills, Written/Oral Communication, Integrity and Trust . 1 year experience in Managed Care/call center handling high-volume calls. Duties: Provide customer service to members, providers, and prospective members . Document all customer contacts into the tracking system. Process complaints and assist supervisory staff with complaints review . Handle escalated issues and assist the management team with specialty projects . Provide administrative support to the Fair Hearings and Complaints Team . Data entry and intake of complaint and fair hearing cases into designated tools. Retrieve documents from various systems to demonstrate compliance with state directives. Collaborate with business partners to gather documentation for responses to state agencies related to complaints and fair hearing requests. Perform other administrative duties as assigned . Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.

Keywords: Pride Health, Harrisonburg , Complaints Coordinator, Administration, Clerical , Amherst, Virginia