Service Coordinator, CCA

Service Coordinator, CCA

HealthPartners is hiring a Service Coordinator, CCA. This position investigates and resolves a wide variety of complex customer questions and issues in a manner which will enhance HealthPartners' reputation as a caring and responsive health care organization. Responsible for providing information and feedback with regard to follow up actions, policies and practices of HealthPartners. The position will provide an improved experience for patients, vendors/providers, and staff.

ACCOUNTABILITIES:

• Investigate and respond to complex customer questions, issues or requests.
• Contact customers to assure accurate understanding of problem.
• Research/collect information necessary to answer the customer's request and communicate resolution to the customer.
• Enters support and intervention activities in CarePartner for services and equipment ordered; enters the correct cost, service and codes.
• Handles provider issues and questions, including billing questions.
• Orders equipment and supplies and follows-up to ensure that equipment was received.
• Works with Case Management Technical Assistants and Claims to resolve RAI's (requests for additional information) or Service Authorization discrepancies.
• Assists in the preparation and research required for audits of claims, billing and department operations.
• Assists other staff members in problem solving where customers are involved.
• Provides data and creates ad hoc reports as requested to assist in identifying trends and areas where quality improvement strategies should be focused.
• As requested, assists in providing necessary documentation for data collection efforts used to analyze customer concerns and to report them to management and other interested departments/agencies.
• Works with claims, patients, and vendors regarding issues with waiver obligations.
• Establishes and maintains good working relationships with colleagues in the department, as well as other areas that support case management including external customers.
• Documents all patient and provider contacts in CarePartner.
• Makes outreach calls to patients and providers as needed and directed.
• Assists in maintaining a cohesive team by contributing to a collaborative, respectful, and diverse environment.
• Participates in, and contributes to appropriate departmental and organizational meetings.
• Communicates effectively with providers, customers, and members resulting in high levels of customer satisfaction.
• Identifies and promptly reports to leadership any potentially adverse situations.
• Maintains confidentiality of information in accordance with department and corporate policies.
• Maintains maximum individual productivity through proficient use of automated systems.
• Willingly participates in various committees, task forces, projects, and quality improvement teams as needed or assigned.
• Performs other duties as assigned.

Specific to the MN Senior Health Options (MSHO) and MN Senior Care Plus (MSC+) position:

• Liaison between HealthPartners and contracted counties.
• Identifies agencies for Elderly Waiver services and make referrals.
• Coordinates the work around Elderly Waiver vendors, authorizations and Requests for Additional Information (RAI) and issues.
• Arranges home visits for patients of the same primary language including arranging interpreter services.
• Uses the Elderly Waiver network database as well as recommendations from staff to identify providers matching the member's needs.
• Uses excellent customer relations, judgment, and Elderly Waiver network knowledge to assist members and providers.

REQUIRED QUALIFICATIONS:

• Bachelor's degree or Associate degree or four years of related experience.
• Minimum of three years customer service experience, preferably in the health care industry.
• Medical Terminology class/training or 1 year related experience.
• Excellent computer skills using Microsoft Word, Excel and e-mail.
• Excellent phone etiquette and customer service skills.
• Excellent oral and written communication skills.
• Good problem solving skills.
• Excellent organizational skills.
• Ability to work independently and within established time frames.
• For SNBC, experience working with persons with disabilities

PREFERRED QUALIFICATIONS:

• Prefer experience with one or more HealthPartners systems such as CarePartner, HCSS, or Epic.
• Previous experience in a health care environment.
• Knowledge of claims payment, waiver services, and managed care.
• Bilingual or previous work experience with a diverse population to enhance the customer experience of members.

DECISION-MAKING:

• Identifies complex questions or situations and consults with the appropriate Supervisor for resolution.
• Makes recommendations to program leadership for service and workflow improvements.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.