Team Lead Care Coordinator

PrimeCare Benefits Group, Inc.™; Las Vegas (NV); À distance; USD 30 000 - 44 000; Plein temps

Résumé du poste

PrimeCare Benefits Group is seeking a Team Lead Care Coordinator to guide and coach the Care Coordination team while partnering with the Senior Lead of Strategic Operations. This remote role demands strong communication, process oversight, and dedication to delivering high-quality dental and vision benefits support.

You will mentor care coordinators, monitor performance, and support workflow improvements to ensure timely processing of referrals and authorizations.

Qualifications

• High school diploma or equivalent.
• Strong verbal and written communication skills.
• Excellent customer service, problem-solving, and organizational abilities.
• Ability to provide guidance and support to coworkers while maintaining a professional and collaborative approach.
• Strong attention to detail and accuracy in data entry and documentation.
• Ability to prioritize multiple responsibilities and work effectively in a fast-paced environment.
• Proficiency with Microsoft Office and the ability to navigate multiple software systems.
• Ability to work independently and maintain accountability in a remote environment.
• Reliable internet connection and a quiet, professional workspace.

Responsabilités

• Provide day-to-day guidance, coaching, and operational support to Care Coordinators.
• Serve as the primary resource for team members regarding referrals, authorizations, eligibility verification, and dental and vision benefit inquiries.
• Monitor daily workloads and assist with distributing tasks to ensure timely completion.
• Train and onboard new Care Coordinators and support ongoing employee development.
• Assist with monitoring productivity, call quality, processing accuracy, and performance standards.
• Identify workflow challenges and recommend improvements to enhance efficiency and customer service.
• Serve as the first point of escalation for complex member, provider, and operational concerns.

Connaissances

Verbal and written communication

Customer service

Problem solving

Organizational skills

Attention to detail

Data entry proficiency

Multi-tasking

Microsoft Office / multiple software

Remote work discipline

Formation

High school diploma or equivalent

Outils

Microsoft Office

Description du poste

Team Lead Care Coordinator – Remote

Company: PrimeCare Benefits Group

Position: Team Lead Care Coordinator

Location: Remote (Occasional Onsite Attendance Required)

Employment Type: Full-Time

FLSA Classification: Non-Exempt (Hourly)

Union Status: Union-Represented Position

Reports To: Senior Lead of Strategic Operations

About The Opportunity

PrimeCare Benefits Group is seeking an experienced, motivated, and customer-focused Team Lead Care Coordinator to join our team!

This position is ideal for someone who enjoys helping others, has strong knowledge of healthcare benefits administration, and is ready to take on a leadership role.

As a Team Lead Care Coordinator, you will serve as a key resource for our Care Coordination team, providing daily guidance, coaching, training, and operational support while ensuring members and providers receive exceptional service.

You will work closely with the Senior Lead of Strategic Operations to maintain performance standards, improve workflows, and support the team's continued success.

This is a remote position with occasional required onsite attendance for meetings, training, and operational needs.

Key Responsibilities

Team Leadership & Support

• Provide day-to-day guidance, coaching, and operational support to Care Coordinators.
• Serve as the primary resource for team members regarding referrals, authorizations, eligibility verification, and dental and vision benefit inquiries.
• Monitor daily workloads and assist with distributing tasks to ensure timely completion.
• Train and onboard new Care Coordinators and support ongoing employee development.
• Assist with monitoring productivity, call quality, processing accuracy, and performance standards.
• Identify workflow challenges and recommend improvements to enhance efficiency and customer service.
• Serve as the first point of escalation for complex member, provider, and operational concerns.
• Assist leadership with quality reviews, reporting, audits, and departmental projects.
• Foster a positive, collaborative, and accountable team environment.

Member & Provider Support

• Answer incoming calls from members, providers, and office staff regarding dental and vision benefit plans.
• Assist with eligibility verification, benefit coverage, referral and authorization status, and general plan inquiries.
• Resolve member and provider concerns professionally, accurately, and efficiently.
• Document all interactions thoroughly in the appropriate systems.
• Collaborate with internal departments to resolve claims, eligibility, authorization, and service-related issues.

Referral & Authorization Processing

• Review, enter, and process dental and vision referrals and authorization requests.
• Ensure referrals and authorizations are processed accurately and within 48 hours of receipt.
• Review submitted requests for completeness and accuracy.
• Assist team members with complex referrals, authorization requirements, and benefit-related questions.
• Support compliance with established procedures, turnaround times, and quality standards.

Quality, Compliance & Performance

• Support call center performance goals, including an abandonment rate below 3% and an average speed to answer of less than 30 seconds.
• Monitor team performance and assist leadership in identifying opportunities for improvement.
• Help maintain accuracy and consistency in referral and authorization processing.
• Ensure professional communication and the protection of confidential member information.
• Follow HIPAA regulations, company policies, and applicable service requirements.
• Participate in leadership meetings, training sessions, coaching, and operational reviews.

Qualifications

Required

• High school diploma or equivalent.
• Strong verbal and written communication skills.
• Excellent customer service, problem-solving, and organizational abilities.
• Ability to provide guidance and support to coworkers while maintaining a professional and collaborative approach.
• Strong attention to detail and accuracy in data entry and documentation.
• Ability to prioritize multiple responsibilities and work effectively in a fast-paced environment.
• Proficiency with Microsoft Office and the ability to navigate multiple software systems.
• Ability to work independently and maintain accountability in a remote environment.
• Reliable internet connection and a quiet, professional workspace.

Preferred

• 1–2 years of customer service or call center experience.
• Previous experience in a team lead, training, mentoring, or coaching capacity.
• Experience in dental, vision, health insurance, or managed care.
• Knowledge of insurance eligibility verification, referrals, and prior authorizations.
• Experience monitoring productivity, quality assurance, and workflow performance.
• Bilingual communication skills.

What We're Looking For

We're Looking For Someone Who Is

• A supportive leader: Enjoys coaching, mentoring, and helping team members succeed.
• Customer-focused: Committed to providing outstanding service to members and providers.
• Detail-oriented: Understands the importance of accuracy, timely processing, and compliance.
• A strong problem-solver: Can confidently address complex situations and recommend practical solutions.
• Organized and dependable: Able to balance individual responsibilities with daily team support.
• Collaborative: Builds positive working relationships and contributes to a productive team environment.
• Adaptable: Comfortable managing changing priorities and supporting operational improvements.

Work Environment & Schedule

• Remote work environment.
• Occasional mandatory onsite attendance for meetings, leadership training, and operational needs.
• Frequent phone communication, computer use, and interaction with team members throughout the workday.
• Ability to remain seated and work at a computer for extended periods.
• Must maintain a professional, distraction-free workspace suitable for handling confidential information.

Additional Position Information

This is a union-represented position subject to the terms and conditions of the applicable collective bargaining agreement.

The Team Lead Care Coordinator provides daily operational guidance and support to Care Coordinators while working closely with the Senior Lead of Strategic Operations to achieve departmental goals.

Why Join Our Team?

At PrimeCare Benefits Group, we are committed to delivering exceptional service and helping members access the dental and vision care they need.

Our Care Coordination team plays an essential role in supporting members, assisting providers, and ensuring referrals and authorizations are processed efficiently and accurately.

As a Team Lead Care Coordinator, you'll have the opportunity to make a meaningful impact by supporting your team, improving processes, and contributing to the overall success of our organization.

PrimeCare Benefits Group is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to qualified applicants without regard to any legally protected status.