Remote Health Services Coordinator — Member Care & Access

Baystate Health; Springfield (MA); Hybrid; USD 32,000 - 44,000; Full time

Benefits offered by this job

Remote work option

Job summary

Baystate Health is seeking a Health Services Coordinator in Springfield, MA to support the Utilization Management team. You will coordinate service requests, communicate benefit decisions, and assist members, providers, and internal teams with education and process improvements.

The role emphasizes strong attention to detail, excellent communication, and the ability to navigate benefits and authorizations while maintaining confidentiality.

Qualifications

• High school diploma or equivalent is required.
• At least 2 years of experience in a medical administrative role within a physician's office, clinic, medical facility, or the insurance industry.
• Knowledge of medical terminology or related training.
• Beginner to intermediate proficiency with Microsoft Word and Excel.
• Strong typing accuracy and attention to detail.
• Excellent problem-solving, organizational, and prioritization skills.
• Strong listening and communication skills, both over the phone and in person.

Responsibilities

• Coordinate service requests and review/process authorizations based on member benefits and guidelines.
• Serve as a primary contact for health services inquiries, explaining benefits, eligibility, procedures, and decisions.
• Complete authorization entry, generate correspondence, audit benefits, and meet productivity standards.
• Assist Case Managers with research, troubleshooting, and administrative support.
• Support other departments and educate members/providers about programs and resources.
• Assist with Medicare Advantage data, CMS guidelines, and government program requirements.
• Protect member confidentiality following HIPAA and regulatory standards.

Job description

Baystate Health is seeking a Health Services Coordinator in Springfield, MA to support the Utilization Management team. You will coordinate service requests, communicate benefit decisions, and assist members, providers, and internal teams with education and process improvements.

The role emphasizes strong attention to detail, excellent communication, and the ability to navigate benefits and authorizations while maintaining confidentiality.