Complaint Coordinator
Magellan Health Services 170 reviews - Washington, DC

This job posting is no longer available on Magellan Health. Find similar jobs:Complaint Coordinator jobs - Magellan Health Services jobs

(

Job Number:
14735

)

JOB SUMMARY:
This position is responsible for responding to all complaints consistent with ADHS/DBHS requirements and tracking complaints for a source of information for quality improvement of the behavioral health system.

Complaint Coordinators must be able to distinguish a complaint from a Title XIX/XXI appeal of an action.

Responsibilities include answering incoming calls, developing a written summary describing the resolution of the complaint within a specified timeframe and refer callers to appropriate MSC translation and oral interpreter services when necessary. Overall, the Complaint Coordinator is expected to provide outstanding service to our internal and external customers and strive to resolve member and provider needs on the first call.

ESSENTIAL FUNCTIONS:
·

Actively listens and probes callers in a professionally and timely manner to determine nature of complaint. Researches caller concerns while maintaining confidentiality.

Consults or refers to a health care professional on decisions requiring clinical judgment.

·

Comprehensively tracks and enters complaint information into the appropriate data system.

Thoroughly documents customers’ comments/information and forwards required information to the appropriate staff.

Performs necessary follow-up tasks to ensure member or provider’s needs are completely met.

·

Lead or participate in as requested that help improve Service Center performance, excellence and culture.

Support team members and participate in team activities to help build a high-performance team.

Demonstrate flexibility in areas such as job duties and schedule in order to aid Service Center in better serving its members and help Magellan achieve its business and operational goals.

Assist MSC efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.

·

Assume full responsibility for self-development and career progression.

Proactively seek and participate in ongoing training (formal and informal) in all aspects of the Complaint Coordinator role.

Assist in the mentoring and training of new Complaint Coordinators.

Remain responsible for updating self on ever changing information to ensure accuracy when dealing with members, providers, ADHS and the public.

NON-ESSENTIAL FUNCTIONS:
Performs various other duties and special projects that are assigned by management on a daily basis while performing their primary function.

SERVICE DELIVERY EXPECTATIONS:
Must be customer service oriented, meet Magellan’s Service standards in all categories on a monthly basis, team player, maintain member and provider Confidentiality at all times, demonstrate effective problem solving skills, and be punctual and maintain good attendance.

MINIMUM REQUIREMENTS:
Education:
BA/BS

Experience:
3-5yrs.

Job Specific: Customer Service

Will accept an equivalent combination of experience and education.

Other:
Excellent verbal and written communication skills, organizational skills required and the ability to handle multiple tasks. Must recognize customer service as an ever-changing environment, this causes one to be flexible in scheduling and having the ability to accept change.

Responsible for meeting call handling requirements and daily telephone standards as set forth by the MSC. Must agree to service observing for the purpose of training and quality control.

Computer Skills: Must be a proficient typist and able to maneuver through various computer

platforms while verifying demographic information on all calls.

PREFERRED QUALIFICATIONS:
Experience: Experience in a Customer Service/Health Care environment

Primary Location

-

AZ-PhoenixAZ-4801 East Washington Street

Work Locations

-

4801 East Washington Street (AZ07)

4129 East Van Buren

Suite B150

Phoenix

Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.

About this company
170 reviews
Magellan Health Services has charted its course to become one of the largest managed behavioral health care companies in the nation. The...