Client Response Coordinator Technical Lead

    • Job Tracking ID: 512935-821595
    • Job Location: Remote, USA
    • Job Level: Mid Career (2+ years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: June 15, 2022
    • Years of Experience: 2 - 5 Years
    • Starting Date: ASAP
    • Salary Type:: Hourly
    • Rate:: 19.64
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Job Description:

The Client Response Coordinator Technical Lead is committed to ensure the necessary processes required to review and issue appeal determination notifications within all applicable turnaround (TAT) guidelines. Manages all appeal internal and external reporting needs. They will have a beneficial impact in the navigation of an intricate appeal process and keep disruption to members and clients at a minimum. This position is key for maintaining accurate and timely management of appeals.

$19.64

Key Functions

  • Manages all detailed internal and external reporting needs.
  • Assists in managing daily and aging inventory.
  • Completes appeals and inventory assigned accurately as a subject matter expert.
  • Assists with any necessary team training and developing.
  • Provides support and assistance with questions from the Appeals Team.
  • Manages all level of appeals and inquiries accurately as a subject matter expert. Ensures compliance with Department of Labor regulations, plan specifications and ERISA turnaround times.
  • Coordinates medical necessity and precertification reviews with appropriate UR vendors.
  • Support specialized tasks corresponding to Transplant Benefit Verifications, Department of Insurance complaints, Attorney and Subpoena requests.
  • Provides Implementation and documentation support for the team.
  • Follows established processes when communicating with other departments to resolve customer and client inquiries.
  • Supports appeals necessitating coordination with the CSC, Account Management, or client due to needing a unique process or clarification.
  • Ensures compliance with HIPAA and HITRUST information security requirements to protect client information.
  • Navigates proprietary software systems to respond to expedited requests.
  • Provide administrative, research and clerical support for the team.
  • Adheres to AmeriBen culture by demonstrating Integrity, Initiative, Good Judgment, and Teamwork.
  • Performs other duties as assigned to ensure individual and group goals are achieved with Accuracy, Customer Service and Timely Turnaround.

Experience and Skills:

  • High school degree, or equivalent.
  • Working knowledge of regulatory guidelines.
  • Proficiency with Microsoft Office products.
  • Strong verbal and written communication skills.

Preferred Qualifications

  • Ability to work efficiently, perform multi-tasking, prioritize tasks, and meet tight deadlines.
  • Strong research and organizational skills.
  • Must be self-directed and work well with others.
  • Types 45 wpm, 10-key, and computer knowledge.

AmeriBen is not yet hiring in the below states:

  • Delaware, Massachusetts, Montana, New Hampshire, New York, North Dakota, Rhode Island, Vermont, District of Columbia and Puerto Rico.

AmeriBen is an Equal Opportunity/Affirmative Action Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com .