Case Management Support Specialist

hace 6 días

Ciudad de México, Ciudad de México Global Excel Management Inc A tiempo completo

Job Overview

Role Purpose and Responsibilities

The Case Management Support Specialist plays a crucial role in assisting with the collection of necessary information to initiate, update, and manage cases effectively. This position also acts as an administrative support resource within the Case Management division.

Key Responsibilities – Including but not limited to:

• Engage in direct communication with clients, customers, and healthcare providers through various channels such as phone and email to gather medical or financial data essential for estimating costs prior to or during patient admissions.

• Maintain thorough documentation of all interactions and communications within the system.

• Provide detailed claims information, including status updates, processing dates, payment amounts, check numbers, and any applicable discounts to clients and providers through necessary outreach.

• Proactively identify potential issues and implement timely corrective measures to prevent escalation that may require supervisory intervention.

• Coordinate medical appointments, which often involves identifying and contacting multiple participating providers that align with patient preferences regarding location and language.

• Determine when specific matters should be escalated to a supervisor or manager.

• Follow up with insured individuals regarding claims within appropriate timeframes to gather updates or missing information.

• Execute administrative tasks as assigned by team leadership in accordance with business needs, including but not limited to requesting financial updates post-service, verifying provider participation, and performing data entry tasks related to policy and claim management.

• Act as a resource for other departments and provide assistance as required.

Required Knowledge, Skills, and Abilities

• Exceptional customer service abilities;

• Strong interpersonal skills and a collaborative mindset;

• High degree of professionalism;

• Effective problem-solving capabilities;

• Highly organized with the ability to manage multiple tasks and prioritize effectively;

• Excellent communication skills;

• Proficient in computer applications, particularly the Microsoft Office suite;

• Keen attention to detail;

• Adaptability and flexibility;

• Strong problem-solving aptitude;

• Positive and results-oriented attitude;

• Self-assuredness;

• Understanding of corporate client culture and expectations.

Qualifications and Experience

• High School diploma or equivalent;

• Over 3 years of experience in a coordination or insurance-related role;

• Bilingual proficiency in English and Spanish;

• Clear and effective communication skills in both English and Spanish, both written and verbal;

• Familiarity with common claims and health insurance terminology;

• Ability to multitask and prioritize effectively;

• Strong follow-up skills;

• Detail-oriented with excellent organizational skills;

• Proficiency in Microsoft Office products.

What We Offer

Global Excel Management Inc provides more than just a job; we offer a professional career path with competitive compensation, including a base salary, performance bonuses, and comprehensive benefits.

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