Customer Service Liaison
hace 2 semanas
Position Summary:
The Client Services Coordinator plays a crucial role at Target Human Resources Solutions, providing exceptional customer service to a diverse range of external contacts, including members, providers, facilities, and internal staff. This key individual assesses client needs in a timely and efficient manner, ensuring optimum operational performance.
Essential Functions:
1. Regulatory Compliance:
Comply with guidelines established by the Centers for Medicare and Medicaid (CMS) and other regulatory agencies, as applicable.
2. Customer Support:
Recognize customer needs and provide assistance in complaint, grievance, or appeal situations.
3. File Management:
Receive, prepare, and manage complaint, grievance, or appeal files, maintaining accurate records.
4. Data Management:
Maintain a record of grievances and appeals using various documentation systems.
5. Investigation and Resolution:
Conduct investigations to resolve complaints, grievances, and appeals in a fair and timely manner.
6. Database Maintenance:
Enter information related to the department into the database, ensuring accuracy and completeness.
7. Notification and Compliance:
Send notifications to beneficiaries and facilities when regulations apply, ensuring timely compliance.
8. Limited Clinical Data Use:
Use clinical data only for review of service requests for completeness, collection and transfer of non-clinical data, and acquisition of structured clinical data, without evaluation or interpretation.
9. Additional Responsibilities:
Perform all other duties assigned by the manager and/or supervisor.
Requirements:
Education:
Bachelor's degree required.
Experience:
Minimum 2 years of experience in a customer service position.
Knowledge:
Knowledge in medical terminology preferred.
Proficiency in Microsoft Office Suite, including Word, Excel, PowerPoint, and Outlook, at the intermediate level or higher.
EEO Statement: Somos un patrón con Igualdad de Oportunidades en el Empleo y tomamos acción afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimentos.
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