Medical Management Care Coordinator

VNS Health; New York (NY); On-site; USD 32,000 - 40,000; Full time

Benefits offered by this job

Referral bonus opportunities

PTO starting at 20 days + 9 holidays

Health insurance plan for you and your

Lif e and Disability

Employer-matched retirement savings

Tuition reimbursement

Pre-tax FSAs for healthcare and Dep.CA

Professional growth and career Adv.

Job summary

VNS Health is hiring for a role focused on data entry and customer service within a clinical setting in New York. You will collect information from clinicians, create and manage case files requiring authorization, and ensure accurate data entry across systems to support timely decisions and claims adjudication.

The position emphasizes providing excellent customer service, problem solving, and adherence to confidentiality while supporting management with training and process improvements.

Qualifications

• High School Diploma or equivalent is required.
• Minimum of two years of experience in a customer service role.
• Excellent oral and written communication skills required.
• Advanced personal computer skills including Word, Excel or Access required.

Responsibilities

• Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
• Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
• Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
• Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
• Provides triage and management of calls ensuring that established call performance targets consistently achieved.
• Provides feedback to leadership regarding training needs
• Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
• Participates in special projects and performs other duties as assigned.

Skills

Customer service

Communication skills

Problem solving

Data entry

Education

High School Diploma or equivalent

Tools

Word

Excel

Access

Job description

Overview

Collects specific data in the medical management information system for the clinical staff. Resolves authorization issues as well as troubleshoots, researches and resolves related issues in a timely and efficient manner. Works under general supervision.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
• Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What You Will Do

• Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
• Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
• Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
• Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
• Provides triage and management of calls ensuring that established call performance targets consistently achieved.
• Provides feedback to leadership regarding training needs
• Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education:

High School Diploma or equivalent required

Work Experience

Minimum of two years of experience in a customer service role required

Excellent Oral And Written Communication Skills Required

Advanced personal computer skills, including Word, Excel or Access required

Utilization Management Experience Preferred

Pay Range

USD $23.17 – USD $28.96 /Hr.

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.