Customer Service Coordinator I

ADP, Inc.; Dallas (TX); On-site; USD 25,000 - 28,000; Full time

Job summary

Qlarant is seeking a Customer Service Coordinator I to handle Medicare Advantage and Prescription Drug program complaints. The role involves interviewing complainants, researching cases, and entering data into the case management system under close supervision.

Ideal candidates have a high school diploma and 0–2 years of experience, with preferred familiarity in call centers and healthcare or Medicare. This is a full-time, on-site position in Dallas, TX.

Qualifications

• Minimum High School Diploma or GED required.
• 0 - 2 years of experience required; 2 - 4 years preferred.
• Call Center experience preferred.
• Data Entry experience preferred.
• Healthcare or Medicare experience preferred.

Responsibilities

• Receives complaints from a variety of sources.
• Interviews complainants or beneficiaries concerning Medicare Advantage or Prescription Drug Programs.
• Researches subjects and beneficiaries of received complaints.
• Communicates with beneficiaries, plans, pharmacies, and providers to resolve complaints.
• Evaluates the facts of a complaint and researches additional information as necessary.
• Compiles findings and determines if appropriate for closure or presentation to Level II team.
• Handles a wide variety of confidential situations.
• Performs data entry of complaints into the case management system and other databases.
• Performs minor background research on subjects of interest for screening complaints.
• Prepares appropriate letter templates or revises content based on facts.

Skills

Call center experience

Data entry

Healthcare/Medicare knowledge

Communication skills

Education

High School Diploma or GED

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Customer Service Coordinator I

Full Time Hourly Coordinator I Dallas, TX, US

Salary Range: $18.00 To $20.00 Hourly

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Receives complaints from a variety of sources. Interviews complainants or beneficiaries concerning the Medicare Advantage or Prescription Drug Programs to determine disposition of case. Researches subjects and beneficiaries of received complaints.

Essential Functions:

• Communicates with beneficiaries, plans, pharmacies, and providers as needed to resolve complaints.
• Evaluates the facts of a complaint and researches additional information as necessary.
• Compiles findings and determines if appropriate for closure or presentation to Level II team.
• Handles a wide variety of confidential situations.
• Performs data entry of complaints into the case management system and a variety of other databases.
• Performs minor background research on subjects of interest as required for the screening of complaints.
• Prepares appropriate letter templates and/or revises the content based on the facts presented in the complaint.
• Communicates with external customers including beneficiary or individual complainants, representatives from the Senior Medicare Patrol, Plan Sponsors, CMS, and others.

Level of Supervision Received:
Under close supervision, works closely with manager to prioritize efforts

Education (can be substituted for experience):
Minimum High School Diploma or GED required

Work Experience (can be substituted for education):
0 - 2 years of experience required; 2 - 4 years preferred
Call Center experience preferred
Data Entry experience preferred
Healthcare or Medicare experience preferred

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.