Customer Service Coordinator

Providing essential support and education to both internal and external customers, the full-time Customer Service Coordinator will manage incoming calls, handle claims and eligibility inquiries, and maintain accurate records in a remote environment during day shifts. Key responsibilities Handle incoming calls, triaging inquiries from providers and health plan members while ensuring timely follow-up on all issues Collect and compile utilization data to assist the Utilization Management department in analyzing medical practice patterns Develop and maintain relationships with claims and health services management departments to resolve issues and educate providers on processes Required qualifications High School diploma or equivalent 3 years of experience in the managed health care field with exposure to patient issues including claims and eligibility 1 year of experience in a high-volume call center Proficiency in medical terminology and basic knowledge of medical treatment regimens Ability to work independently in research and decision-making processes