Care Coordination Specialist I

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Paid volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a detail-oriented professional to support Clinical Operations as a liaison among Members, Physicians, Delegates, and Care Coordinators. The role emphasizes data collection, case documentation, and timely coordination of benefits.

You will handle clinical and non-clinical information, perform pre-review screening, assist with case management, and communicate with providers and members to resolve issues.

Qualifications

• High School Diploma or GED required.
• Prefer 1–2 years customer service or medical support experience.
• Knowledge of medical terminology.

Responsibilities

• Review service requests for completeness and collect structured data.
• Document and route cases for clinical review; initiate calls to members and providers.
• Coordinate benefits and answer questions about services.
• Assist Case Management and Letters team in processing inquiries.

Skills

Medical terminology

Communication skills

Decision making

Team player

Education

High School Diploma or GED

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a detail-oriented professional to support Clinical Operations as a liaison among Members, Physicians, Delegates, and Care Coordinators. The role emphasizes data collection, case documentation, and timely coordination of benefits.

You will handle clinical and non-clinical information, perform pre-review screening, assist with case management, and communicate with providers and members to resolve issues.