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Service Coordinator HARP job

CenteneGetzville, NY
Centene jobs

Company

Salary

Skills

Benefits

Job Description

Service Coordinator HARP

Position Purpose: The HARP Service Coordinator provides administrative and non-clinical member service support for members of the HealthierLife plan. The HARP Service Coordinator provides front-line response to members and providers requesting information on or access to Behavioral Health services. The position facilitates access, for clinical case management staff, to non-emergency care and triage requests as well as urgent and emergency care requests.

Coordination and Documentation: Coordinates services and care related to HARP members, including scheduling appointments for Members, arranging transportation to appointments when necessary, obtaining health records from providers, identifying and securing providers for the Members, obtaining and documenting authorization information, placing appointment reminder and follow-up calls,
Complete all required and related paperwork and documentation in information systems/ electronic record (i.e. authorizations, securing provider assignments, etc.)
Data Input and Retrieval: Utilize computer systems in order to input orders, data, authorizations, access records and retrieve pertinent information when necessary.
Troubleshooting Customer Problems: Clarify the member's complaint; determine the cause of the problem; select and explain the best solution to solve the problem and expedite correction or adjustment; follow up to ensure resolution.
Computer Literacy: Transcribe, format, input, and edit information or data in order to generate letters, documents, spreadsheets, and authorizations. Proficient with Microsoft Office.
Spreadsheets: Create spreadsheets with appropriate data in order to provide others with required operational reports.
Care Coordination - nonclinical: Liaison to providers and care team regarding care processes. Problem solving of nonclinical issues. Assures timely access to clinical staff for triage and resolution of clinical issues
Care Management & Utilization Management Documentation: Complete documentation of care management support activities and creation and processing of prospective Utilization Management requests
Care Management support: Routine contact with members, providers, and Health Homes to facilitate referrals and follow through on services based on care plan, as directed by Care Manager.; Complete related documentation of support activities.
HARP Program Support: Alert department of any suspected fraudulent activity. Authorizations and closing of cases.
HARP Care Manager Support: Assist HARP Care Managers doing high acuity clinical cases. Assist with reports, generating letters, follow up phone calls, and other requirements.
Other duties as required: Job performance requires fulfilling other incidental or related duties as assigned, assisting and training others, and performing duties of higher rated positions from time to time for developmental purposes.

Education/Experience: High School Diploma required. Associate or Bachelors degree preferred. 1-2 Years Managed Care/Behavioral Health Insurance Experience Preferred
Minimum 1 Year Customer Service Experience: Ensure timely and professional interactions with customers. Good working knowledge of recovery oriented Behavioral Health services preferred. Good working knowledge managed care insurance concepts and regulations preferred. 1 to 2 years related experience required.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Health Insurance Operations

USA-New York-Getzville

Fidelis Care

Full-time
Estimated annual salary
$42,372
average
Minimum
$33,270
Maximum
$60,994

TASKS

  • Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
  • Check to ensure that appropriate changes were made to resolve customers' problems.
  • Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
  • Resolve customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.

SKILLS

  • Reading ComprehensionUnderstanding written sentences and paragraphs in work related documents.
  • Active ListeningGiving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • WritingCommunicating effectively in writing as appropriate for the needs of the audience.
  • SpeakingTalking to others to convey information effectively.

KNOWLEDGE

  • Administration and ManagementKnowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  • ClericalKnowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
  • Economics and AccountingKnowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.
  • Sales and MarketingKnowledge of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.
Disability Insurance
Health Insurance

Centene

Type

Company - Public (CNC)

Size

10000+ employees

Revenue

Over $10B

Location

Saint Louis, MO

Industry

Insurance

Founded

1984

CEO

Michael F. Neidorff

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