What are the responsibilities and job description for the Operations Coordinator position at Medical Associates?
Medical Associates Health Plans is hiring an Operations Coordinator to support our Member Services team! This position will provide ongoing education to staff, assist with day-to-day operations within the department and ensure processes are compliant with state laws, employer contracts, policies and company procedures.
Benefits Package Includes:
- Single or Family Health Insurance with discounted premium rates for wellness program participation.
- 401k with immediate matching (50% on the dollar up to 7% of pay) additional annual Profit Sharing
- Flexible Paid Time Off Program (24 days off/year)
- Medical and Dependent Care Flex Spending Accounts
- Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.
Major Duties and Responsibilities:
- Assists with the growth and performance of the team. Assists in the selection/interviewing of new hires, assists in the training. Works with the Auditors, Trainer and Management team to provide ongoing education to staff and ensure resource material is available and up to date. Works with all related departments to ensure systems are configured correctly, authorizations and enrollment are appropriate, and benefits are communicated accurately. Assist in the evaluation and documentation of staff performance.
- Identifies, monitors and manages the prioritization of daily tasks as required by the regulatory agencies and State laws to ensure processes are being addressed in the mandated time frames such as appeals, audits, etc.
- Provide coordination support for day-to-day operations, working with the Manager to ensure effective prioritization and workflows for staff. Assist with establishing staff schedules.
- Provide customer service to claimants, providers, pharmacies and clients in resolving customer issues according to plan policy.
- Assist operational departments to ensure timely resolution of claims, enrollment and authorizations.
- Complete all other projects and duties as assigned.
Knowledge and Skills:
Experience Three years to five years of similar or related experience.
Education Equivalent to a high school education.
Interpersonal Skills A significant level of trust and diplomacy is required, in addition to normal courtesy and tact. Work involves extensive personal contact with others and/or is usually of a personal or sensitive nature. Work may involve motivating or influencing others. Outside contacts become important and fostering sound relationships with other entities (companies and/or individuals) becomes necessary.
Other Skills Insurance plan management program (AMYSIS). Proven leadership and training skills. Critical thinking and problem-solving skills. Familiar with State and Federal regulations.
