Customer Care Coordinator

and Job Summary:

As a Customer Care Coordinator, you will be the primary point of contact for our members, providing them with excellent service and support throughout their experience with the Collaborative Care Clinical Team. Your responsibilities will include managing member inquiries, workloads of the clinical team, identifying escalations, resolving member issues, being a point of contact for HR leads and ensuring an overall positive member experience.

Responsibilities:

1. Clinical Team & Member Support:

 First point of contact for new member inquiries.

 Ensure responses to member inquiries within 24-48 hours via phone, email, or text.

 Evaluate clinical teamwork boards to assure timely outreaches during steerage review.

 Identify escalations based on specific member needs via HR, TPA or situation.

 Evaluate and prepare responses to HR, Advisors, plan partners on member experience cases.

 Support the nurses with follow-ups, additional outreaches, and document submissions.

2. Care Steerage Support:

 Evaluate and prepare Level 1 member requests for care option(s) steerage.

 Deliver care option(s) within 24-48 hours to member and TPA via text, email, or fax.

Level 1:

 Chiropractic

 Durable Medical Equipment

 Diagnostic Imaging – Standard (Xray, US)

3. Account Management:

 Maintain member accounts, and updates, ensuring accurate records and interactions using our CRM system.

4. Cross-Functional Collaboration:

 Collaborate with client advisors, plan partners and others necessary to ensure a seamless customer experience and identify opportunities for improvements.

 Work closely with the Director of Member & Client Experience on all aspects of the role.

5. Documentation:

 Maintain all reference materials, workflows, and other documentation to support the Collaborative Care operations.

6. Member Education:

 Educate members, TPA’s, plan partners about our purpose, services, best practices, and more to enhance their understanding and satisfaction.

Requirements:

1. Excellent Communication Skills: Strong verbal and written communication skills with the ability to effectively listen and respond with members and internal team members.

2. Problem-Solving Skills: Proven ability to identify gaps, analyze problems, and develop practical solutions in a fast-paced environment. Ability to look outside the box at the bigger picture.

3. Customer Focus: A strong, genuine passion for delivering an exceptional member experience and a commitment to exceeding their expectations.

4. Organizational Skills: Must be highly organized and have strong multi-tasking abilities with the capacity to manage multiple priorities and deadlines effectively.

5. Team Player: Ability to work productively, positively, and cooperatively within cross-functional teams while being a leader in the position.

6. Attention to Detail: Keen attention to detail and accuracy in documentation and in evaluation of member needs.

7. Technical Proficiency: Microsoft Suites

Education:

A high school diploma or equivalent is required. A bachelor's degree in business administration, communications, health sciences, or related field is advantageous but not mandatory. Health insurance, and medical terminology awareness are advantageous, but not mandatory.

Working Conditions:

This role typically operates in an office environment with the flexibility to work from home. Some flexibility in working hours may be required to accommodate member needs, including some evenings and weekends.

Conclusion:

As a Customer Care Coordinator, you will play a vital role in the Collaborative Care Clinical Team. This role is the quarterback of the overall team, assuring all work is being done timely, member outreaches are scheduled timely and effectively, and the nurses are supported as needed.

Job Types: Full-time, Part-time

Pay: From $45,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Shift:

• Day shift

Work setting:

• Hybrid work

Ability to Relocate:

• Green Bay, WI 54304: Relocate before starting work (Required)

Work Location: Hybrid remote in Green Bay, WI 54304