Care Coordinator
About The Position
PrimeCare Benefits Group is hiring a dependable, detail-oriented, customer-focused Care Coordinator to serve as a primary point of contact for members and healthcare providers. The role supports dental and vision benefit inquiries, eligibility verification, referrals, and authorization requests. It is a remote position with occasional required onsite attendance for meetings, training, and other business needs. The position is full-time, non-exempt, hourly, and union-represented, subject to the applicable collective bargaining agreement. It reports to the Lead Care Coordinator.
Requirements
- High school diploma or equivalent.
- Strong verbal and written communication skills.
- Excellent customer service and problem-solving abilities.
- Strong organizational skills and attention to detail.
- Ability to multitask and navigate multiple computer systems simultaneously.
- Proficiency in Microsoft Office and general computer applications.
- Ability to work independently, manage time effectively, and meet performance expectations in a remote environment.
- Reliable internet connection and a quiet, professional workspace.
- Ability to remain seated and work at a computer for extended periods.
- Ability to maintain a professional, distraction-free workspace suitable for handling confidential information.
Nice To Haves
- 1–2 years of customer service or call center experience.
- Experience in dental, vision, health insurance, or managed care.
- Familiarity with insurance eligibility verification, referrals, and prior authorizations.
- Previous experience working in a high-volume call center.
- Bilingual communication skills.
Responsibilities
- Answer incoming calls from members, providers, and office staff about dental and vision benefit plans.
- Assist callers with eligibility verification, benefit coverage, referral and authorization status, and general plan questions.
- Provide friendly, professional, accurate customer service; research and resolve inquiries, escalating complex matters when necessary.
- Maintain thorough and accurate documentation of interactions.
- Review, enter, and process dental and vision referrals and authorization requests accurately and within 48 hours of receipt.
- Review submitted information for completeness and accuracy.
- Coordinate with internal departments to resolve eligibility, claims, and authorization concerns.
- Follow established procedures to support timely processing and compliance.
- Meet established productivity, accuracy, and customer service standards, including call-center performance goals for an abandonment rate below 3% and average speed to answer under 30 seconds.
- Protect confidential member information and comply with HIPAA requirements.
- Participate in team meetings, training sessions, and ongoing professional development.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
