Customer Service Coordinator

Job Summary

Providing essential support and education to both internal and external customers, the full-time Customer Service Coordinator will manage incoming calls, handle claims and eligibility inquiries, and maintain accurate records in a remote environment during day shifts.

Key responsibilities

• Handle incoming calls, triaging inquiries from providers and health plan members while ensuring timely follow-up on all issues
• Collect and compile utilization data to assist the Utilization Management department in analyzing medical practice patterns
• Develop and maintain relationships with claims and health services management departments to resolve issues and educate providers on processes

Required qualifications

• High School diploma or equivalent
• 3 years of experience in the managed health care field with exposure to patient issues including claims and eligibility
• 1 year of experience in a high-volume call center
• Proficiency in medical terminology and basic knowledge of medical treatment regimens
• Ability to work independently in research and decision-making processes