Care Coordination Specialist

Healthfirst; Pennsylvania; On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Dental and vision coverage

401k contributions

Incentive programs

Job summary

Healthfirst is seeking a Support Coordinator to assist care/case managers with non-clinical activities, including case creation, authorizations, and member outreach. The role interfaces with care management, utilization, behavioral health, and other teams to ensure timely and accurate processing while maintaining HIPAA compliance.

Key duties include handling authorizations, managing high caseloads, and building trusted relationships with members and providers.

Qualifications

• Requires a high school diploma or GED.
• Experience in a customer service environment.
• Ability to work in a fast-paced setting.
• Language skills in Spanish, Russian, French, Creole, Mandarin, or Cantonese are a plus.
• Knowledge of medical terminology is beneficial.
• Experience in managed care or healthcare Call Center environments is preferred.
• Experience with Customer Relationship Management systems and multi-technology workflows is a plus.
• Strong communication and documentation skills.

Responsibilities

• Provides excellent quality customer service to members and/or providers related to authorizations and care coordination.
• Handles calls to/from providers about authorizations, referrals, visits, tests, and faxed care plans.
• Manages requests from members, providers, call centers and care management teams for authorizations and corrections.
• Completes member and provider notification calls.
• Escalates calls to appropriate departments as needed.

Skills

Customer service

Fast-paced environment

Education

High School diploma or GED

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

Healthfirst is seeking a Support Coordinator to assist care/case managers with non-clinical activities, including case creation, authorizations, and member outreach. The role interfaces with care management, utilization, behavioral health, and other teams to ensure timely and accurate processing while maintaining HIPAA compliance.

Key duties include handling authorizations, managing high caseloads, and building trusted relationships with members and providers.