Service Coordination Asst I El Paso Health
Service Coordination Asst I El Paso Health
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Salary Not Disclosed
1 Vacancy
Job Description
Job Summary
Addresses and resolves complex member and Provider telephonic inquires related to Long Term Service and Support (LTSS) benefits and service coordination specifically STARPLUS requirements for eligibility (nondual and dual membership) benefits (waiver and nonwaiver) authorizations claims reimbursement levels of care electronic visit verification valueadded services and provider network. Answers inbound calls and initiates outbound calls to members and Providers in support of service coordination activities that include but are not limited to conducting surveys completing screening/assessments and gathering detailed information for the members interdisciplinary team (i.e. demographic details nonmedical drivers of health needs clinical information etc.. Carries out all call center activities and supports with other departments within El Paso Health (EPH) as necessary. Available to answer Automated Call Distribution (ACD) line during the Health and Human Services Commission (HHSC) mandated hours of operation (Monday through Friday 8am 5pm MST).
Skills
1. Strong interpersonal verbal and written communication skills.
2. Strong problemsolving skills and collaborating with other professional and nonclinical staff.
3. Ability to interpret policies and procedures and communicate complex topics effectively.
4. Effective communication skills with a diverse audience to include customers providers and vendors.
5. Excellent skills in researching and interpreting data.
6. Ability to understand complex situations and interpersonal dynamics to effectively handle escalated customer and coworker needs.
7. Ability to create copy edit send and save documents spreadsheets and correspondence utilizing Microsoft Word Microsoft Excel and Microsoft Outlook.
8. Must be able to navigate a PC to open applications send emails and conduct data entry.
9. Ability to work independently and exercise sound judgment in interactions with physicians payors and members/families.
10. Great attention to detail.
11. Ability to multitask prioritize and manage time efficiently.
12. Bilingual (English and Spanish) is highly preferred.
Work Experience
Two years of healthcare experience is required preferably in a managed care environment in related area of responsibility (i.e. call center environment longterm care home health hospice public health or assisted living). Knowledge of Texas Medicaid Medicare and health plan processes preferred. Knowledge of medical terminology preferred. Experience as a customer service representative in a medical office or health plan preferred. Strong knowledge of the MS Office suite (Microsoft Excel Word and PowerPoint programs) is required.
License/Registration/Certification
None.
Education and Training
High school diploma or equivalent is required.
Employment Type
Full-Time
