APS Healthcare provides health services to our member populations, with the goal of improving the health of those we serve. We have an exciting opportunity for a Client Services Coordinator II based in our Harrisburg, PA office.
You will have an exciting opportunity to be part of the implementation and operation of Accountable Care Organizations (ACOs) aimed at increasing care coordination, improving quality of care and reducing costs for Medicare members. ACOs are designed to achieve the TripleAim of Better Care, Improved Health and Lower Per Capita Costs. Members will receive care that is equitable to all who seek it and available when needed. Improved health will be accomplished through prevention and chronic care management. The aim of the ACO is intended to reduce the trend of cost increases associated with the Medicare fee for service population.
The Customer Service Coordinator III provides customer service and conducts intake in a call center environment. This key individual communicates with a wide variety of external contacts including members, providers, facilities, claims payers, and insurance companies.
• Provide member education and/or instruction specific to the service they requested through mailings and research. Provide a record of customer’s call through timely documentation in operating system.
• Confirm member is eligible for services through verification of plan eligibility, plan coverage and APS responsibility for requested service.
• Maintain a high level of customer satisfaction with timely problem resolution. Meet internal and external timeliness criteria by answering call within contractual obligations and completing post-call work in a timely manner including generation of customer communication materials and general assessments.
• Identify areas that need process/procedure improvement/modification and offer logical, viable, results oriented solutions.
• Other duties as assigned.
• High School Diploma or equivalent required.
• Associates Degree strongly desired.
• Minimum 3-5 years customer service experience in a position that required. ownership for resolution of customer’s issue in the healthcare industry is required.
• Call center experience required.
• Internet and web-based systems experience.
• Knowledge of Medical terminology required.
• Knowledge of the healthcare industry required.
• Knowledge of Medicare/Medicaid required.
• Excellent communication skills and ability to interact with people in a culturally diverse environment.
• Strong ability to read and comprehend instruction related to customized products.
• Strong ability to multi-task and work independently or as part of a team to meet customer expectations as well as internal and external standards.
• Maintain customer and employer confidentiality.
• Ability to combine multiple resources to resolve customer issue.
• Ability to hear what is not stated – Example: Recognize when customer is frustrated or may require education or instruction beyond the issue presented.
• Ability to de-escalate conflict situations with minimal team lead or supervisory assistance but recognize when a situation is beyond individual training/expertise and requires assistance.
APS Healthcare - 9 months ago