Contact Center Care Coordinator I

Crossroads Staffing • Camarillo, CA, United States • $200k - $250k / year • 1d ago

Contact Center Coordinator Needed in Camarillo

Job Description
The Contact Center Care Coordinator is responsible for providing outstanding customer service and support to members, caregivers, and healthcare professionals. This role involves managing inbound and outbound calls, emails, and other communication channels to support members in accessing healthcare services, scheduling appointments, and addressing inquiries regarding medical procedures, billing, and general information enrollment, eligibility, provider network authorization, claim status, plan guidelines and processes. This position handles inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status, general program and administration questions including direct member requests for I.D cards and Primary Care Physician (PCP) changes, and triaging calls to appropriate units or outside entities. All interactions are documented in the system of record. Provide members essential information regarding access to care, coordination of care, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Troubleshoot and resolve escalated issues following established protocols and guidelines to escalate urgent matters or complex issues to appropriate personnel. Provide accurate and up-to-date information about medical procedures, services, and facilities. Collaborate with healthcare providers and internal teams to ensure efficient and accurate communication of member needs and information. Assist providers and members in using the Interactive Voice Response (IVR) and web portal. Ensure department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to the protection of personal history information. This includes adherence to compliance standards, confidentiality, and data protection regulations in all interactions and communications. Properly document all calls/contacts as required by department standards in a timely, clear, and concise manner using the internal tracking system.

Skills Required
HS Diploma or GED. 2+ years of experience in customer service. Bilingual in Spanish. Strong communication skills. Proficient in MS Office. Data entry skills with the ability to type 35 WPM.

Skills Preferred
Prior experience in a healthcare setting or call center is a plus. Experience working with Electronic Health Records (EHR) systems or CRM software is a plus.

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