Care Coordinator

Who we are 

Healthcare is more confusing, more costly, and more complex than ever. Transcarent is a health and care experience company on a mission to empower Members to stay healthy by providing them with unbiased information, trusted guidance, and easy access to high value care where and when they need it.  You will be part of a world-class team, supported by top tier investors like 7wireVentures and General Catalyst, and founded by a mission-driven team committed to transforming the health and care experience for all. We closed on our Series C funding in January 2022, raising our total funding to $298 million and enabling us to respond to the demand for rapid expansion of our offering. 

Transcarent is committed to growing and empowering a diverse and inclusive community within our company. We believe that a team with diverse lived experiences, working together will strengthen our organization, and our ability to deliver "not just better but different" experiences for our members. 

We are looking for teammates to join us in building our company, culture, and Member experience who: 

• Put people first, and make decisions with the Member’s best interests in mind
• Are active learners, constantly looking to improve and grow
• Are driven by our mission to measurably improve health and care each day
• Bring the energy needed to transform health and care, and move and adapt rapidly
• Are laser focused on delivering results for Members, and proactively problem solving to get there 

In this role you will...  

The role of the Care Coordinator is to work with members to coordinate and guide members through their Transcarent Surgery Care experience. In this caseload carrying role, you will have an opportunity to improve members’ lives.  

Responsibilities include answering the phone, educating members on their benefits; uploading documents into the computer system; coordinating members surgical care with providers, obtaining precertification authorizations, working in collaboration with internal and external customers to ensure a flawless experience for our members. The Care Coordinator will interface with intake coordinator, records management, travel coordinator, and clinical contacts provider locations.  

 

What you'll do  

• Facilitate patients successfully through the surgery review process, exceeding expectations while meeting the program metrics 
• Communicate and follow-up with plan members to ensure understanding of the program while delivering exceptional customer service 
• Coordinate the scheduling and approval process from receipt of a qualified lead for surgery to patient placement
• Responds to inquiries from assigned members via multiple modes of communication including phone, chat, email and in-app messaging
• Efficiently and effectively manage a case load across a variety of clients and surgical categories and update platform with pertinent information and status of cases
• Obtain the necessary information – demographic, financial, clinical and other pertinent data to complete referral process
• Collaborate with providers, clinics and facilities, and various levels of management to effectively resolve issues
• Obtain pre-authorizations
• Works effectively with other supporting operational roles and internal departments, to coordinate the member’s case
• Effectively address and resolve patient barriers to utilize the benefit 
• Maintain confidentiality and knowledge of HIPAA regulations
• Demonstrate Transcarent core values
• Comply with company policies
• Be willing and available to work overtime as needed  

What we're looking for  

• 2 to 4 years’ customer relationship and phone center experience 
• Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), CRM tools (Salesforce), IM/video conferencing (Slack/Zoom), and contact center-style phone systems 
• Excellent customer service, written and verbal communication and interpersonal skills
• A “delight the customer” attitude
• Prior healthcare industry experience with a working knowledge of medical terminology and health benefits claim process
• Strong organizational, critical thinking and problem-solving skills
• Strong attention to detail and follow-through
• Prior experience managing a high-volume caseload
• Openness and understanding that dynamic environments include change, and welcoming that change with a positive attitude
• A designated, distraction-free home office space with ability to hard wire connect to high-speed internet (no Wi-Fi)
• Pacific or Mountain Time preferred – available to work 9:3