Managed Care Coordinator
Job Summary
Supporting Clinical Operations, the full-time Managed Care Coordinator will manage service requests, coordinate communication between members and providers, and assist with case management tasks in a remote environment.
Key responsibilities
- Review service requests for completeness and gather necessary clinical and non-clinical data
- Coordinate communications with members and providers to clarify benefits and case details
- Assist members in finding providers and resolving issues related to obtaining services and filing appeals
Required qualifications
- High School Diploma/GED required
- 1-2 years of experience in customer service or a medical support role preferred
- Knowledge of medical terminology; familiarity with Medicaid CM preferred
- Ability to make sound decisions under supervision
- Proficiency in using personal computers and applicable software systems
Complete Job Description
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