Healthcare Coordinating Specialist

Essential Job Duties and Responsibilities :

The role of the Beneficiary Coordinating Specialist (BCS) is to coordinate the medical appointments between medical providers and beneficiaries for Japan-based claimants under the DOD US Federal Employee Health Benefit (FEHB) Program. The BCS is responsible for overall case management and coordinating with CNs to ensure beneficiaries are sent to the right health care providers. The BCS will also provide guidance to NSLO regarding provider availability shortages.

Description :

• To assist beneficiaries with coordinating medical appointments with Japan local health providers
• Manage all existing open cases on behalf of Civilian employees of the DOD US Federal Employee Health Benefit (FEHB) Program in line with the relevant operational procedures.
• Attend to all new appointment requests in a timely and professional manner in co-ordination with guidance from CNs .
• Maintain clear and accurate case notes / records and within the relevant systems and tools to ensure the case reflects the most up to date status.
• Take ownership of all urgent cases and use proper escalation procedures.
• Escalating cases and requests where required and providing updates to stakeholders in a timely manner.
• Make outbound calls to follow up with beneficiaries and providers on claims queries, when appropriate
• Respond to all queries from beneficiaries and providers with a solutions focused mindset.
• Remaining up to date with all updated protocols and procedures.
• Work closely with Customer Operations Specialists, Coordinating Nurses and related stakeholders to close cases in a timely manner
• Work closely with the Network Manager and Network Services Liaison officers to communicate network requirements (eg increased availability, network gaps)
• Maintain effective relationship with our providers.
• Effectively manage and communicate workload and movements to line manager.
• Demonstrating a professional, positive, caring, and empathetic approach when assisting callers.
• Recognize and log customer feedback in our systems so it can be used for quality improvement and taking responsibility for service recovery.
• Strictly complying with applicable privacy policies.
• Consistently demonstrating our company values; working within and promoting all International SOS policies and procedures.

Requirements

For New Graduates】

For Experienced Candidates】

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