MetroPlusHealth
Join to apply for the
Customer Service Complaints Coordinator
role at
MetroPlusHealth 1 day ago Be among the first 25 applicants Join to apply for the
Customer Service Complaints Coordinator
role at
MetroPlusHealth This range is provided by MetroPlusHealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$50,000.00/yr - $56,897.00/yr Empower. Unite. Care.
MetroPlusHealth
is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlus Health
provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health 's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health
has been committed to building strong relationships with its members and providers.
Position Overview
The CS Complaints Coordinator provides comprehensive customer service to members, providers, and prospective members. The primary responsibilities include but are not limited to documenting all customer contacts into the tracking system, process complaints, assisting supervisory staff with complaints review, handle escalated issues and assist the management team with specialty projects.
Work Shifts
9:00 A.M – 5:00 P.M
Duties & Responsibilities
Perform reviews of complaints and correctly determine and enter complaint review results per the regulatory requirements for Complaints. Have a full understanding of the complaint handling process from initiation/acknowledgement to closure/resolution. Create complaint reports and enter initial complaint log details Inform appropriate members of the management team about patterns in complaints that are averse to the plan. Utilize other experts as needed to ensure clear understanding / investigation of applicable issues Perform complaint related investigations Investigate complaint details to determine root cause Complete a Complaint Summary report of complaints being worked on and identify if Corrective / Preventive Action is required Process and close complaints in a timely manner Update complaint log with closure details Assist specialist with escalated issues: i.e., transportation requests, specialty appointments Assist management staff with special projects: i.e., PCP monthly projects (IT-Assignments, PCP error reports) Record and respond to all Customer contacts and update in tracking system. Manage and ensure appropriate follow-up and closure for all customer contacts Provide on-site as well as telephone orientations to new and existing members Process and resolve complaints and record given information in the system Assist members with the selection and assignment of PCP’s Update all member demographic changes Provide all benefit/service-related information to members, perspective members and providers Perform retention efforts for all lines of business Assist with the handling of overflow Medicare calls, special projects, and outreach projects when necessary Handle roster inquiries Handle disenrollment inquiries from members, providers and regulatory agencies Handle provider inquiries Respond to all claim billing inquiries from providers and members. All other duties and special assignments as assigned by the Complaints Supervisor and Manager
Minimum Qualifications
Bachelor’s degree required; and 1 year of relevant call center experience including experience with reviewing/resolving complaints; or A satisfactory equivalent combination of education, training, and experience.
Professional Competencies
Integrity and Trust Customer Focus Functional/Technical skills Written/Oral Communication
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs
#MHP50
Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Other Industries Hospitals and Health Care Referrals increase your chances of interviewing at MetroPlusHealth by 2x Sign in to set job alerts for “Customer Service Coordinator” roles.
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Customer Service Complaints Coordinator
role at
MetroPlusHealth 1 day ago Be among the first 25 applicants Join to apply for the
Customer Service Complaints Coordinator
role at
MetroPlusHealth This range is provided by MetroPlusHealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$50,000.00/yr - $56,897.00/yr Empower. Unite. Care.
MetroPlusHealth
is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlus Health
provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health 's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health
has been committed to building strong relationships with its members and providers.
Position Overview
The CS Complaints Coordinator provides comprehensive customer service to members, providers, and prospective members. The primary responsibilities include but are not limited to documenting all customer contacts into the tracking system, process complaints, assisting supervisory staff with complaints review, handle escalated issues and assist the management team with specialty projects.
Work Shifts
9:00 A.M – 5:00 P.M
Duties & Responsibilities
Perform reviews of complaints and correctly determine and enter complaint review results per the regulatory requirements for Complaints. Have a full understanding of the complaint handling process from initiation/acknowledgement to closure/resolution. Create complaint reports and enter initial complaint log details Inform appropriate members of the management team about patterns in complaints that are averse to the plan. Utilize other experts as needed to ensure clear understanding / investigation of applicable issues Perform complaint related investigations Investigate complaint details to determine root cause Complete a Complaint Summary report of complaints being worked on and identify if Corrective / Preventive Action is required Process and close complaints in a timely manner Update complaint log with closure details Assist specialist with escalated issues: i.e., transportation requests, specialty appointments Assist management staff with special projects: i.e., PCP monthly projects (IT-Assignments, PCP error reports) Record and respond to all Customer contacts and update in tracking system. Manage and ensure appropriate follow-up and closure for all customer contacts Provide on-site as well as telephone orientations to new and existing members Process and resolve complaints and record given information in the system Assist members with the selection and assignment of PCP’s Update all member demographic changes Provide all benefit/service-related information to members, perspective members and providers Perform retention efforts for all lines of business Assist with the handling of overflow Medicare calls, special projects, and outreach projects when necessary Handle roster inquiries Handle disenrollment inquiries from members, providers and regulatory agencies Handle provider inquiries Respond to all claim billing inquiries from providers and members. All other duties and special assignments as assigned by the Complaints Supervisor and Manager
Minimum Qualifications
Bachelor’s degree required; and 1 year of relevant call center experience including experience with reviewing/resolving complaints; or A satisfactory equivalent combination of education, training, and experience.
Professional Competencies
Integrity and Trust Customer Focus Functional/Technical skills Written/Oral Communication
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs
#MHP50
Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Other Industries Hospitals and Health Care Referrals increase your chances of interviewing at MetroPlusHealth by 2x Sign in to set job alerts for “Customer Service Coordinator” roles.
Manhattan, NY $40,000.00-$42,000.00 1 month ago New York, NY $61,000.00-$65,000.00 22 hours ago Seasonal Client Experience Coordinator - Soho 1
New York City Metropolitan Area $17.00-$19.00 3 weeks ago New York City Metropolitan Area 4 months ago New York City Metropolitan Area 3 months ago Customer Service Representative - NYC Flagship
New York City Metropolitan Area $17.00-$19.00 4 days ago New York City Metropolitan Area 2 months ago Customer Service Representative - State Farm Agent Team Member
Client Experience Coordinator (Long-Term Temporary Assignment) - Hudson Yards
New York, NY $70,022.00-$70,022.00 3 weeks ago Retail Customer Service Associate II (12-20hrs/wk)
Customer Service Representative - State Farm Agent Team Member
Jersey City, NJ $40,000.00-$65,000.00 6 months ago New York, NY $50,000.00-$56,897.00 4 days ago Customer Service Representative - State Farm Agent Team Member
New York City Metropolitan Area $20.00-$24.00 1 week ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr