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Allied Benefit Systems · 16 hours ago

Enhanced Case Management Coordinator III

United States

Full-time

Remote

Mid Level

$23/hr - $23/hr

3+ years exp

Allied Benefit Systems is a company focused on providing healthcare solutions, and they are seeking an Enhanced Case Management Coordinator III. This role involves supporting department staff with administrative tasks related to members' medical conditions and managing audits while engaging with members to offer support and resources.

Health CareInsuranceWellness

Responsibilities

Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products

Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system

Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders

Collaborate with strategic vendor partners to provide supportive services and support to members

Lead and facilitate claims auditing in conjunction with ECM Coordinators

Complete department auditing related to daily tasks to ensure accuracy and identify escalations

Identify impactful scenarios through appropriate closing summaries in timely fashion

Share impactful scenarios with the department’s leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership

Identifying escalations for department leadership team, as appropriate

Other duties as assigned

Qualification

Administrative supportPatient-provider engagementMedical terminologyBenefit plan designAnalytical skillsAccountabilityFunctional/Technical skillsCommunicationCustomer focusProblem-solving

Required

Bachelor's Degree or equivalent work experience, required

At least 3-5 years of administrative support experience required

Strong verbal and written communication skills

Strong analytical and problem-solving skills

Preferred

Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred

Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes

Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc