Member Services Support Coordinator - Call Center - Paramount

Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based company, headquartered in Toledo, has more than 685 employees dedicated to serving their health plan members.  

Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.

In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.

As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website at paramounthealthcare.com.

POSITION SUMMARY

This position provides Paramount front desk/reception and phone duties, reporting, administrative and processing support to the Member Services team at the main Paramount office (Plaza building) at downtown headquarters.

ACCOUNTABILITIES

• Triages or handles incoming phone calls on the main Paramount phone line.
• Greets and assists walk-in guests including members, vendors, or front door deliveries. Follows all related security policies and procedures.
• Works with the Member Services Analyst(s) with department reporting related to call center, service form tracking and trending, call center representative productivity, performance guarantee reporting, live chat, and email communications, and other key performance indicators.  Runs and analyzes other reports as needed at the direction of department team leaders.  Maintain reports to support NCQA, HEDIS, regulatory, quality requirements, or other daily functions as needed. 
• Coordinate the processing of incoming mail and fax correspondence through the Macess Doc Triage system.  Utilize other key systems, departments, or personnel to gather needed information for processing.
• Assists in member-submitted requests for reimbursement for both pharmacy and medical services. Coordinates and assists with member mailings (i.e. print letters, fold and stuff envelopes for mail).  Supports remote staff with printing needs.
• Monitors and coordinates the processing of documentation for the ProMedica Steps2Health program.
• Supports the maintenance of department policies and procedures as needed.
• Performs other duties as assigned.

REQUIRED QUALIFICATIONS

Education:  Associate degree or >5 years of relevant job experience

Skills:

• Microsoft Office & other basic computer-based tasks</span>
• Excellent interpersonal skills and ability to work with others
• Ability to plan, coordinate and organize multiple priorities
• Must have excellent organization skills, ability to work independently, and attention to detail.
• Ability to operate standard office equipment including copier and phones

Years of Experience: 1-2 years of experience

License: NA

Certification: NA

PREFERRED QUALIFICATIONS

Education: Bachelor’s Degree

Skills:  Macess applications, Reporting experience, Data analytics, Proficiency in a multi-line phone system  

Years of Experience:  N/A

License: NA

Certification: NA

WORKING CONDITIONS

Personal Protective Equipment:  N/A

Physical Demands:  Must be able to move about business offices.  Ability to operate common office machinery and communicate on telephones. Ability to move between company workstations/departments and may be required to stoop, reach and lift loads up to 20 pounds.

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio.  For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace