Case Resolution & Provider Coordination Specialist

Aston Carter; Warrenville (IL); Híbrido; USD 32.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account

Transportation benefits

Employee Assistance Program

Time Off/Leave

Descripción de la vacante

Aston Carter is seeking a qualified candidate for a permanent hybrid position based in Warrenville, IL. The role focuses on case management and provider coordination, requiring strong communication and problem-solving skills to manage complex claims.

You will work across multiple teams, handle provider interactions, and ensure timely processing. Training lasts several weeks, with a schedule including weekdays and weekend options, and a robust benefits package is available to eligible employees.

Formación

• 2+ years of case management or customer service experience handling complex issues.
• Experience in operations coordination, dispatch, or similar roles.
• Proficient with Microsoft Office Suite (Excel and Word) for data entry and reporting.
• Strong written and verbal communication with providers, customers, and internal teams.
• Demonstrated critical thinking to understand, analyze, and negotiate in complex situations.
• Detail-oriented with accurate data entry and documentation.
• Ability to respond with urgency on emergency/high-priority claims.
• High School Diploma or GED required.

Responsabilidades

• Manage daily interactions with providers to ensure timely dispatch and handling of claims.
• Arrange providers to complete claims when in-network options are unavailable.
• Monitor service request hubs to ensure timely action and resolution.
• Handle inbound/outbound calls with providers, customers, and internal teams.
• Respond to email inquiries regarding claim status and service requests.
• Process provider inquiries and assist with special handling claims.
• Maintain provider profiles and data in company systems.
• Interpret contract language related to enrollments and agreements.
• Coordinate emergency and urgent work orders with customers and contractors.
• Research non-contracted providers and arrange one-time agreements.
• Negotiate terms for urgent work orders balancing customer needs.
• Dispatch work orders per guidelines with accurate details.
• Generate requests using systems such as Agent Desktop and CMS.
• Review open claims and follow up with contractors to drive completion.
• Document activities and maintain records in systems.
• Develop relationships with vendors, customers, and internal teams.
• Engage with potential new provider leads and provide clear support.
• Follow policies for daily tasks ensuring compliance.
• Monitor emergency claims and ensure quick resolution.
• Identify providers in specific geographic areas to assign claims.
• Provide overflow support to Provider Support team.

Conocimientos

Case management

Customer service

Communication

Critical thinking

Attention to detail

Urgent handling

Multitasking

Educación

High School Diploma or GED

Herramientas

Microsoft Office

Excel

Word

Descripción del empleo

Aston Carter is seeking a qualified candidate for a permanent hybrid position based in Warrenville, IL. The role focuses on case management and provider coordination, requiring strong communication and problem-solving skills to manage complex claims.

You will work across multiple teams, handle provider interactions, and ensure timely processing. Training lasts several weeks, with a schedule including weekdays and weekend options, and a robust benefits package is available to eligible employees.