Support Coordinator - UMI

Healthfirst; México; A distancia; MXN 200,000 - 400,000; Jornada completa

Descripción de la vacante

A healthcare organization is seeking a dedicated customer service representative to manage calls and provide support related to authorization updates, care coordination, and member services. The ideal candidate should have a high school diploma and prior customer service experience in a fast-paced environment. Proficiency in Microsoft Office and strong communication skills are essential. This position emphasizes building relationships and ensuring compliance with health information standards.

Formación

• Prior experience in a customer service environment.
• Working experience in a fast-paced environment.
• Knowledge of medical terminology preferred.

Responsabilidades

• Provide excellent quality customer service to members and providers.
• Manage requests from members, providers, and call centers.
• Document accurate member information in compliance with procedures.

Conocimientos

Customer service experience

Proficient in Microsoft Office Suite

Independent thinking and problem solving

Excellent verbal and written communication

Educación

High School diploma or GED

Descripción del empleo

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

Minimum Qualifications:

• 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

Preferred Qualifications:

• 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

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.