Coordinator - Transportation Services Call Center

Position Summary/Position
Under the general direction of the Transportation Services Manager and Supervisor, the Transportation Services Call Center Coordinator is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested to determine eligibility for Transportation Services. This position requires that one be organized, ability to multitask with a working knowledge of call center operations and/ or referral processes. The Transportation services Coordinator will also ensure that provider calls are responded to in an accurate and timely manner while always maintaining highest level of customer service. Major Functions (Duties and Responsibilities)
1. Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.
2. Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.
3. Responsible for meeting accuracy standards for appropriate authorizations of referrals.
4. Ensure key performance indicator goals are met monthly.
5. Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering calls for the Transportation Services Department.
6. Communicate with providers in consultation with the Utilization Management Nurse, regarding authorizations, modifications, denials, and other matters pertinent to processing authorization requests or other UM related correspondence.
7. Assist Management or Utilization Management Nurses as requested.
8. Provide Members with health plan education in regard to Transportation benefit coverage, including understanding coordination of benefit and eligibility rules.
9. Meet IEHP and Transportation Services Call Center standard and policy requirements. This includes but is not limited to the following: successful completion of Transportation Services Training, active participation in continuous training, use telephone system and other IEHP equipment appropriately and for professional reasons only, follow required call scripts and adhere to Attendance/Punctuality and Dress Code policy.
10. Provide superior service that delights caller in all aspects of the interaction including:
a. Strive to assist caller on the first point of contact. Demonstrate a high level of patience and respect; avoid distractions to ensure each caller is assisted promptly and appropriately; follow call handle standards and objectives.
b. When necessary present cases to Transportation Services Management Team and work with other departments to resolve Member and/or Provider inquiries and/or issues.
c. Document accurately while speaking with the caller. Over 100% call documentation is required.
d. Proper and timely intake of Member grievances.
11. Coordinate telephonic translation of calls when Members do not speak English or Spanish.
12. Demonstrate a commitment to understand and adhere to the Regulatory requirements as they relate to the business unit.
13. Preserve Member’s confidentiality by authenticating callers (submitting guardianship documents for verification, establish guardianship alerts, authentication passwords and confidentiality alerts as needed).
14. Demonstrate a commitment to LEAN by participating in process improvement projects and RIE Events/Huddles.
15. Assist with tracking trends within the department and escalating this information to management.
16. Review call monitors recordings and develop self-action plans to improve quality assurance scores. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications
Two (2) years of call center experience in a customer service environment. Experience in data entry. Preferred Experience
Experience as a referral coordinator preferably in an HMO or Managed Care setting preferred. Education Qualifications
High school diploma or GED required. Preferred Education
Associate's degree or Bachelor's degree from an accredited instituion preferred. Professional Certification Professional Licenses Drivers License Required No Knowledge Requirement
Requires knowledge of call center operations, data entry and referral process. Skills Requirement
Proficiency in Microsoft Office Suite and Windows based programs. Typing- Minimum 35 wpm, good grammar and spelling skills are necessary. Excellent oral communication skills. Abilities Requirement
Ability and willingness to learn and follow direction in a fast-paced call center environment and maintain understanding of referral processing. Candidate must feel comfortable with learning and using computer programs. Excellent punctuality and attendance are required. Ability to remain courteous when dealing with difficult or challenging callers is critical to this position. Positive Attitude and ability to work in a team setting. High level of patience. Ability to work independently within specified time constraints. Ability to adapt and perform duties efficiently when unexpected changes arise. Adherence to specific work schedule is required. Works well in a fast-paced environment. Efficient problem solving, time management, initiative, and focus skills requiring minimum supervision and guidance. Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel ; talk or hear; and . The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Sitting - CONSTANTLY Indoors - FREQUENTLY Lighting - CONSTANTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY
A reasonable salary expectation is between $45,884.80 and $55,993.60, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.