Client Services Coordinator 2
About The Position
The Client Services Coordinator 2 / G&A provides outstanding customer service to external contacts—including members, providers, and facilities—as well as clinical and operational staff. The role assesses internal and external clients’ needs in a timely and efficient manner to support optimum operational performance and is fully dedicated to Quality Department duties. The position does not conduct utilization management review activities requiring interpretation of clinical information. The coordinator supports complaints, grievances, and appeals by receiving and preparing case files, maintaining records and databases, conducting investigations, and sending required correspondence. Use of clinical data is limited to checking service requests for completeness, collecting and transferring non-clinical data, acquiring structured clinical data, and activities that do not require evaluation or interpretation of clinical information. The role also performs other duties assigned by the manager and/or supervisor.
Requirements
- High school diploma required.
- Minimum of 2 years of experience in a customer service position.
- Intermediate-level computer experience with Microsoft Word, Excel, PowerPoint, and Outlook.
- The position does not perform utilization management review activities requiring interpretation of clinical information.
Nice To Haves
- Bachelor’s degree preferred.
Responsibilities
- Comply with guidelines established by the Centers for Medicare and Medicaid (CMS) and other applicable regulatory agencies.
- Recognize customer needs and assist with complaints, grievances, or appeals.
- Receive, prepare, and manage complaint, grievance, or appeal files.
- Maintain records of grievances and appeals using various documentation operating systems.
- Conduct investigations to resolve complaints, grievances, and appeals.
- Maintain the department database by entering information and send letters to beneficiaries and facilities when regulations apply.
- Monitor and comply with deadlines for sending notifications to beneficiaries and facilities.
- Use clinical data only to review service requests for completeness, collect and transfer non-clinical data, acquire structured clinical data, and perform activities that do not require evaluation or interpretation of clinical information.
- Perform other duties assigned by the manager and/or supervisor.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
