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Customer Service & Member Relations Project Coordinator - Full Time, Days (Orange) at Prospect Medical Systems - CA

Posted in General Business 30+ days ago.

Type: Full-Time
Location: Orange, California





Job Description:

Customer Service & Member Relations Project Coordinator - Full Time, Days (Orange)

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Customer Service & Member Relations Project Coordinator's responsibilities will consist of working with internal and external parties to organize the various components needed to initiate, run and conclude assigned projects. Provide administrative support to the Customer Service and Member Relations departments.

Job Responsibilities/Duties


  • Responsible for routing and working Member Relation/ Member Retention change form Queue.
  • Performs Quality Checks for PCP Terminations Change forms by Inspecting the Referring PCP's Health Plan IDS/ contracted locations on Health Plan websites and PMG website.
  • Route change forms to the next group after quality check is performed.
  • Obtain PCP membership report from Aerial or IDX.
  • Responsible for obtaining biographies for the referring PCP, along with mail merges and sending PCP term notification letters to members.
  • Responsible for creating excel call list spreadsheets for PCP Termination Retention Outreach assigned to MR coordinators/representatives.
  • Completes mail merge projects as assigned.
  • Responsible for updating tracking logs for Representative's Weekly Assignments.
  • Responsible for maintaining department logs and reports.
  • Responsible for checking email accounts (Senior & Member Retention).
  • Responsible for Reconciling Taxi Log Invoices.
  • PCP Term, Welcome Letter, MSS Outbound calls.
  • Responsible for checking member/provider e-mails & voicemail boxes.
  • Assist Member Relations Representative with NMO events.
  • Track the outcome of all retention efforts.
  • Assist with member inbound calls as needed.
  • Thoroughly verify HIPAA requirements to ensure account accuracy.
  • Other duties as assigned.

Qualifications

Minimum Education: Bachelor's Degree preferred. High School Diploma or equivalent required.

Minimum Experience: A minimum of two years of customer service experience in a call center environment required. A minimum of two to three years of IPA/HMO experience. One year of experience in project management required. Excellent written/verbal/presentation skills. Ability to effectively present information and respond to questions from managers, employees, clients, customers, and the general public. Must have intermediate reasoning and problem-solving abilities and planning skills. Ability to interpret a variety of instructions furnished in written, oral, diagram, and schedule form. Self-driven, results-oriented, and focused on high quality. Strategic thinker with analytical skills. Ability to work independently with minimal supervision. Strong attention to detail with the ability to cultivate and build strong business relationships internally and externally. Ability to project excellent customer service, negotiation, and conflict resolution skills vias telephone in a fast-paced environment while maintaining a professional demeanor. Advanced working knowledge of Microsoft Programs (PowerPoint, Word, and Excel). Ability to multi-task, prioritize, and work in a fast-paced environment. Bilingual preferred.

Req. Certification/Licensure: None.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive:


  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www.eeoc.gov/





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