Care Coordination Specialist: Member Support

Healthfirst; Pennsylvania; Vor Ort; USD 42.000 - 52.000; Vollzeit

Benefits dieser Stelle

Medical coverage

Dental coverage

Vision coverage

401k contributions

Life insurance

Incentive programs

Zusammenfassung

Healthfirst is seeking a Support Coordinator to assist care/case managers with non-clinical tasks, including case creation, member outreach, and processing authorizations. The role supports education for members and providers, handles calls, and maintains documentation to improve care access and cost outcomes.

You'll join a fast-paced team, manage a sizeable caseload and collaborate with multiple departments. Prior customer service experience and strong written communication are essential.

Qualifikationen

• High School diploma or GED equivalent.
• Experience in a customer service environment.
• Experience working in a fast-paced environment that requires handling multiple priorities simultaneously.
• Excellent verbal and written communication skills.

Aufgaben

• Conduct outreaches for newly enrolled members to review current and approved services, DME and additional requests.
• Review intake documents for pre-approved services and elevate discrepancies as needed.
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM.
• Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable.
• Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances.
• Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans.
• Provide education to members and providers regarding requirements for approval of service requests.
• Manage a large caseload while communicating member issues or needs and monitoring screening of members effectively to improve quality and cost outcomes.
• Communicate with Inter/Intra-departments regarding reconciling onboarding issues.
• Additional duties as assigned

Kenntnisse

Customer service

Communication skills

Multitasking

Written communication

Ausbildung

High School diploma or GED

Tools

Trucare

Salesforce

HHAXchange

DocuSign E spaces

Sharepoint

Jobbeschreibung

Healthfirst is seeking a Support Coordinator to assist care/case managers with non-clinical tasks, including case creation, member outreach, and processing authorizations. The role supports education for members and providers, handles calls, and maintains documentation to improve care access and cost outcomes.

You'll join a fast-paced team, manage a sizeable caseload and collaborate with multiple departments. Prior customer service experience and strong written communication are essential.