High School diploma or GED from an accredited institution
Prior experience in a customer service environment
Working experience in a fast-paced environment
Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook
Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese.
Knowledge of medical terminology
Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
Experience navigating multiple technologies including a Customer Relationship Management System (i.e., locate information, route future actions, notate resolutions, update member information, etc.)
Proven track record of exercising independent thinking, problem solving and achieving goals
Excellent verbal and written communication and the ability to document grammatically correct emails, communications, and presentations
Know Your Rights
Benefits
Health insurance
Additional Information
The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; managing authorizations; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities.
Duties and Responsibilities:
Provides excellent quality customer service to our members and/or providers relating to authorization updates, questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention
Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans
Manage requests from members, providers, call centers and care management teams regarding initial authorizations, authorization updates and/or corrections
Complete member and provider notification calls
Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Care Managers
Manages a large volume of tasks and caseloads from multiple queues
Meets/Exceeds all performance, quality and productivity measures
Builds sustainable relationships of trust through open and interactive communication with internal and external customers
Documents accurate member information in compliance with our internal procedures
Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately
Timely communicates member issues or needs and monitors screening of members effectively to improve quality and cost outcomes
Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines
Additional duties as assigned
Healthfirst · Remote