Business Title Medical Management Care Coordinator at Visiting Nurse Service of New York d/b/a VNS Health
Visiting Nurse Service of New York d/b/a VNS Health · New York, United States Of America · Hybrid
- Professional
- Office in New York
What We Provide
Referral bonus opportunities
Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer-matched retirement saving funds
Personal and financial wellness programs
Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement
Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.
What You Will Do
Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
Provides triage and management of calls ensuring that established call performance targets are consistently achieved.
Provides feedback to leadership regarding training needs
Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
Participates in special projects and performs other duties as assigned.
Education:
High School Diploma or equivalent Required
Work Experience:
Minimum of two years of experience in a customer service role Required
Excellent oral and written communication skills Required
Advanced personal computer skills, including Word, Excel or Access Required
Utilization Management experience Preferred
