avature
Support Coordinator - Spanish Fluency
Healthfirst
Remote, USA
Full-time
Entry
Remote
USD 34900-54570 yearly / year
Discovered 1 weeks ago
Free
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Description and Requirements
- Job Profile Summary The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; managing authorizations; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities.
Duties and Responsibilities
- Provides excellent quality customer service to our members and/or providers relating to authorization updates, questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention
- Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans
- Manage requests from members, providers, call centers and care management teams regarding initial authorizations, authorization updates and/or corrections
- Complete member and provider notification calls
- Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Care Managers
- Manages a large volume of tasks and caseloads from multiple queues
- Meets/Exceeds all performance, quality and productivity measures
- Builds sustainable relationships of trust through open and interactive communication with internal and external customers
- Documents accurate member information in compliance with our internal procedures
- Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately
- Timely communicates member issues or needs and monitors screening of members effectively to improve quality and cost outcomes
- Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines
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