Team Lead Care Coordinator

Primecare Benefits • Las Vegas, NV

13h • Remote

About The Position

PrimeCare Benefits Group is seeking an experienced, customer-focused Team Lead Care Coordinator to provide daily guidance, coaching, training, and operational support to the Care Coordination team. The role supports strong service to members and providers while helping maintain team performance standards, improve workflows, and support departmental goals. The position works closely with the Senior Lead of Strategic Operations and is remote, with occasional required onsite attendance for meetings, training, and operational needs. It is a full-time, hourly, non-exempt, union-represented position subject to the applicable collective bargaining agreement.

The Team Lead is a primary resource for Care Coordinators on referrals, authorizations, eligibility verification, and dental and vision benefit inquiries. The role also answers incoming calls, resolves concerns, documents interactions, processes dental and vision referrals and authorizations, and supports quality, compliance, and operational performance. Referrals and authorizations must be processed accurately within 48 hours of receipt. The role requires protecting confidential member information and following HIPAA regulations, company policies, and applicable service requirements.

Requirements

• High school diploma or equivalent.
• Strong verbal and written communication skills.
• Excellent customer service, problem-solving, and organizational abilities.
• Ability to guide and support coworkers professionally and collaboratively.
• Strong attention to detail and accuracy in data entry and documentation.
• Ability to prioritize multiple responsibilities and work effectively in a fast-paced environment.
• Proficiency with Microsoft Office and ability to navigate multiple software systems.
• Ability to work independently and maintain accountability in a remote environment.
• Reliable internet connection and a quiet, professional workspace.

Nice To Haves

• 1–2 years of customer service or call center experience.
• Previous experience in a team lead, training, mentoring, or coaching capacity.
• Experience in dental, vision, health insurance, or managed care.
• Knowledge of insurance eligibility verification, referrals, and prior authorizations.
• Experience monitoring productivity, quality assurance, and workflow performance.
• Bilingual communication skills.

Responsibilities

• Provide day-to-day guidance, coaching, and operational support to Care Coordinators.
• Serve as the primary resource for team members regarding referrals, authorizations, eligibility verification, and dental and vision benefit inquiries.
• Monitor daily workloads and help distribute tasks to support timely completion.
• Train and onboard new Care Coordinators and support ongoing employee development.
• Assist with monitoring productivity, call quality, processing accuracy, and performance standards.
• Identify workflow challenges and recommend improvements to efficiency and customer service.
• Serve as the first point of escalation for complex member, provider, and operational concerns.
• Assist leadership with quality reviews, reporting, audits, and departmental projects.
• Foster a positive, collaborative, and accountable team environment.
• Answer incoming calls from members, providers, and office staff about dental and vision benefit plans.
• Assist with eligibility verification, benefit coverage, referral and authorization status, and general plan inquiries.
• Resolve member and provider concerns professionally, accurately, and efficiently.
• Document interactions thoroughly in the appropriate systems.
• Collaborate with internal departments to resolve claims, eligibility, authorization, and service-related issues.
• Review, enter, and process dental and vision referrals and authorization requests accurately and within 48 hours of receipt.
• Review submitted referral and authorization requests for completeness and accuracy.
• Assist team members with complex referrals, authorization requirements, and benefit-related questions.
• Support compliance with established procedures, turnaround times, and quality standards.
• Support call center performance goals, including an abandonment rate below 3% and an average speed to answer under 30 seconds.
• Monitor team performance and help leadership identify opportunities for improvement.
• Help maintain accuracy and consistency in referral and authorization processing.
• Ensure professional communication and protect confidential member information.
• Follow HIPAA regulations, company policies, and applicable service requirements.
• Participate in leadership meetings, training sessions, coaching, and operational reviews.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED