CGA Triage Coordinator

Dallas, IA - USA

Monthly Salary: Not Disclosed

Posted on: 2 days ago

Vacancies: 1 Vacancy

Job Summary

Were hiring a CGA Triage Coordinator to join our CG&A team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.

About the role:

(You will play a critical role in the initial management and routing of all member complaints grievances and appeals. You will be responsible for the timely and accurate intake categorization and prioritization of incoming cases. By ensuring that each case is promptly triaged and assigned to the appropriate liaison the Coordinator directly supports the teams ability to meet strict regulatory deadlines and maintain the highest standards of member and provider service.

You will report into the CGA Team Lead.

Work Location: This is a remote position open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $22.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

Receive log and process all incoming complaints grievances and appeals through various channels including mail fax email and internal systems.
Monitor and manage case queues proactively flagging urgent cases and assigning them to the appropriate liaison or team.
Identify investigate and triage incoming documents within determined SLAs
Collaborate with colleagues specialists and Leads to identify trends and roadblocks
Utilize internal tools and resources seamlessly
Escalate updates or incorrect information in the internal knowledge management system for Member and Provider Services
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

1 years of customer support/service experience
Excellent organizational and time management skills
Foundational knowledge of escalations or complaints grievances and appeals processes

Bonus points:

Experience in a Complaints Grievances or Appeals department
Experience using CRM and knowledge management tools to resolve issues
Experience using ticket management and reporting tools
Experience managing an assignment caseload
Healthcare and/or SAAS experience

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. Were on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts within the base pay set forth above are determined by factors including your relevant skills education and experience. Full-time employees are eligible for benefits including: medical dental and vision benefits 11 paid holidays paid sick time paid parental leave 401(k) plan participation life and disability insurance and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known.

California Residents: For information about our collection use and disclosure of applicants personal information as well as applicants rights over their personal information please see our .

Required Experience:

Were hiring a CGA Triage Coordinator to join our CG&A team.Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone t...