What are the responsibilities and job description for the Service Coordination Asst I, El Paso Health position at University Medical Center of El Paso?
Job Summary
Addresses and resolves complex member and Provider telephonic inquires related to Long Term Service and Support (LTSS) benefits and service coordination, specifically STAR PLUS requirements for eligibility (non-dual and dual membership), benefits (waiver and non-waiver), authorizations, claims reimbursement, levels of care, electronic visit verification, value-added services, and provider network. Answers inbound calls and initiates outbound calls to members and Providers in support of service coordination activities that include but are not limited to conducting surveys, completing screening/assessments, and gathering detailed information for the member’s inter-disciplinary team (i.e. demographic details, non-medical drivers of health needs, clinical information etc.). Carries out all call center activities and supports with other departments within El Paso Health (EPH) as necessary. Available to answer Automated Call Distribution (ACD) line during the Health and Human Services Commission (HHSC) mandated hours of operation (Monday through Friday 8am – 5pm MST).
Skills
1. Strong interpersonal, verbal and written communication skills.
2. Strong problem-solving skills and collaborating with other professional and non-clinical staff.
3. Ability to interpret policies and procedures and communicate complex topics effectively.
4. Effective communication skills with a diverse audience to include customers, providers and vendors.
5. Excellent skills in researching and interpreting data.
6. Ability to understand complex situations and interpersonal dynamics to effectively handle escalated customer and co-worker needs.
7. Ability to create, copy, edit, send and save documents, spreadsheets and correspondence utilizing Microsoft Word, Microsoft Excel and Microsoft Outlook.
8. Must be able to navigate a PC to open applications, send emails, and conduct data entry.
9. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and members/families.
10. Great attention to detail.
11. Ability to multitask, prioritize and manage time efficiently.
12. Bilingual (English and Spanish) is highly preferred.
Work Experience
Two years of healthcare experience is required, preferably in a managed care environment in related area of responsibility (i.e. call center environment, long-term care, home health, hospice, public health or assisted living). Knowledge of Texas Medicaid, Medicare and health plan processes preferred. Knowledge of medical terminology preferred. Experience as a customer service representative in a medical office or health plan preferred. Strong knowledge of the MS Office suite (Microsoft Excel, Word and PowerPoint programs) is required.
License/Registration/Certification
None.
Education and Training
High school diploma or equivalent is required.
