Health Services Coordinator
17 hours ago
Role: Provide administrative support to Service Coordinator for member services, including non-waiver and waiver services, member contact, education, and community resource coordination.
Essential Duties:
- Answer incoming faxes, emails, and phone requests.
- Initiate member phone calls, identify issues, and refer to appropriate departments.
- Schedule and document appointments.
- Receive and document initial requests, gather data, and refer to appropriate specialists.
- Screen and evaluate calls, referring as necessary.
- Gather data for statistics and maintain logs.
- Manage intake of MNLOC and ISP requests.
- Monitor portal for assessments and reassessments.
- Communicate MNLOC review progress and decisions.
- Document decisions and update due dates in the system.
- Complete eligibility and benefit data before routing.
- Provide communication and education on case management and transition services.
- Educate members on managed care, benefits, and community resources.
Knowledge and Skills:
- General business and computer knowledge.
- Medical terminology training.
- Excellent written and verbal communication skills.
- Customer service skills and phone etiquette.
- Ability to handle high volume of calls and multitask.
- Experience in electronic charting.
Required Qualifications:
- High School Diploma or GED.
- 2+ years of experience with MS Word, Excel, and Outlook.
- Experience in long-term care, home health, hospice, public health, or assisted living.
- Bilingual in Spanish and English.
Preferred Qualifications:
- Experience as case management support staff or customer service representative in a medical office or health plan.
- Associate’s Degree.
- Experience in managed care environment.
- Experience with Texas STAR+PLUS program or similar programs.
- Knowledge of Medicare/Medicaid dual population.
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