The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; 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 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
- Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Care Managers
- Manages a large member caseload
- Meets/Exceeds all performance KPIs including but not limited to quality and productivity
- 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
- Additional duties as assigned
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Minimum Qualifications:
- High School diploma or GED from an accredited institution
- Prior experience in a customer service environment
- Working experience in a fast-paced environment
- Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook
Preferred Qualifications:
- Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese.
- Knowledge of medical terminology
- Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
- Experience navigating multiple technologies including a Customer Relationship Management System (i.e., locate information, route future actions, notate resolutions, update member information, etc.)
- Proven track record of exercising independent thinking, problem solving and achieving goals
- Excellent verbal and written communication and the ability to document grammatically correct emails, communications, and presentations
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.