CLINICAL SERVICES REPRESENTATIVE

COOPER PEDIATRICS; Cape May Court House (NJ); On-site; USD 32,000 - 52,000; Full time

Job summary

Cooper University Health Care in New Jersey is seeking a customer communications specialist to serve as the primary contact for employees, members, physicians, and providers. You will handle inquiries about benefit coverage, medical services, appeals, grievances, and provider access, ensuring responses align with the Plan and policies.

Responsibilities include resolving routine issues within 3 rings, providing clerical and telephone support for the Case Management program, keeping provider files

Qualifications

• High school graduate or GED.
• Previous computer experience preferred.
• Good communication and customer services skills.
• Experience with LOS client support services, Epic, Sunquest, LIS and COPIA System user activity.
• Pleasant and professional attitude, including well developed interpersonal skills.
• Ability to make progress on multiple assignments under time constraints.

Responsibilities

• Responsible for communication between all customers via telephone and resolve inquiries per Plan and policies.
• Provide clerical and telephone support for the Case Management program and maintain provider file compliance.
• Refer unsolved inquiries to the appropriate analyst for resolution and ensure timely responses within 3 rings.

Skills

Communication skills

Customer service

Multitasking

Education

High school diploma or GED

Tools

Epic

Sunquest

LIS

COPIA System

Job description

About us

About Cooper University Health Care

Cooper University Health Care is a leading academic health system affiliated with Cooper Medical School of Rowan University. Cooper, headquartered in Camden, New Jersey, has revenues of more than $3 billion and an A+ credit rating from both S&P and Fitch Ratings.

Cooper has nearly 14,000 team members, including more than 2,200 nurses, more than 1,200 employed physicians representing 95 specialties and subspecialties, and more than 700 advanced practice providers.

Cooper operates MD Anderson Cancer Center at Cooper as well as three hospitals – its 663-bed flagship Cooper University Hospital in Camden, its 229-bed Cooper University Hospital Cape Regional in Cape May Court House, and Children’s Regional Hospital in Camden.

Cooper University Hospital in Camden is the only Level 1 trauma center in South Jersey and the busiest in the region. The hospital has been recognized as a top-performing regional hospital by U.S. News & World Report’s Best Hospitals annual survey for six years.

More than 2.54 million patients visit Cooper’s facilities annually. Cooper’s ambulatory network encompasses three outpatient surgery centers, seven urgent care centers, a wound care center, and more than 130 physician, physical therapy, and radiology offices extending from the Delaware River to the New Jersey shore.

Cooper was named one of America’s Best Large Employers for 2026 by Forbes, ranking among the top 200 in the nation.

Visit CooperHealth.orgto learn more.

Short Description

Responsible for communication between all customers via telephone. Customers include employees, members, physicians, referral sources, and providers. The communication includes, benefit coverage, medical services, appeals and grievances, provider access and availability, claims investigation. Research inquiries and demonstrates a strong ability to resolve issues according to the Plan document and policies and procedures. Refers unsolved inquiries and corrections to the appropriate analyst for resolution. Achieves maximum time effectiveness and customer service by answering all incoming phone calls within 3 rings. Provides clerical and telephone support for Case Management program. Maintains provider file compliance according to directive. Performs duties as assigned by Supervisor within the scope of knowledge and skill

Experience Required

• Previous computer experience preferred
• Good communication and customer services skills.
• Experience with LOS client support services, Epic, Sunquest, LIS and COPIA System user activity.
• Pleasant and professional attitude, including well developed interpersonal skills.
• Ability to make progress on multiple assignments under time constraints.

Education Requirements

• High school graduate or GED.