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Customer Support Coordinator, South San Francisco, CA


Organization: Health Plan of San Mateo
Category: Professional
Location: South San Francisco, CA
Date Job Posted: March 4, 2020
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CUSTOMER SUPPORT COORDINATOR

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Customer Support Coordinator to implement HPSM’s Grievance and Appeals process by resolving complaints filed by HPSM members and their representatives. The essential duties and responsibilities will include the following:

  • Research and resolve member complaints for all lines of business ensuring compliance with HPSM’s Grievance and Appeals policies and procedures.
  • Maintain grievance and appeals case files in HPSM’s data base.
  • Effectively communicate with members and providers verbally and in writing.
  • Prepare summaries and write resolution letters for members, which include summarizing member complaints and steps taken to resolve complaints in clear and grammatically correct language.
  • Attend and present cases at bi-weekly Staff Grievance and Appeals Committee.
  • Prepare files for appeals to regulatory agencies.
  • Maintain current on all regulatory requirements as they apply to grievance and appeal processes.

Requirements:

Education and Experience: Associate’s degree in health, business, social sciences, or humanities, preferred. Two (2) years of experience working with Medi-Cal or Medicare in a managed care environment preferred. Work performing grievance and appeals processing preferred. Work in a call center, claims department, and/or other customer service position required

Knowledge of: Medicare, Medi-Cal, Managed Care and medical terminology preferred. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint.

Ability to: Communicate effectively and professionally, both verbally and in writing. Summarize information clearly, thoroughly, and quickly in writing. Deal with difficult people and situations while providing quality customer service. Use sound judgment, identify next steps to be taken and develop appropriate solutions. Collaborate with multiple parties to solve problems as well as the ability to solve problems independently.

Compensation and Benefits

Starting Compensation Range: - Depending on Experience

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.

Other Requirement: Fluency in Spanish, Tagalog or Chinese (Mandarin/Cantonese) languages are highly preferred.

How to Apply

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email careers@hpsm.org or via fax: (650) 616-8039. File by: Continuous until filled. The Health Plan of San Mateo is proud to be an Equal Opportunity Employer and encourages minority candidates of all backgrounds to apply.

Submissions without a Cover Letter and Salary Expectations may not be considered.


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