Clerical Support Coordinator

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $23 - $24 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Allied Benefit Systems

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1980

⚕️ Healthcare Insurance

🤝 B2B

Healthcare Insurance • B2B

Allied Benefit Systems is a national healthcare solutions company that provides health plan administration, care and cost management, provider network services, and data analytics to employers, members, and benefits consultants. The company focuses on reducing healthcare costs, optimizing plan performance, and improving member experience through administrative services, analytics & insights, and customizable provider networks.

📋 Description

• Manage high volumes of inbound and outbound member and provider calls, CRM-routed requests, emails, and digital submissions; validate account and eligibility details; and document all interactions and actions taken in accordance with internal quality standards. • Enter, update, and verify member, provider, and employer-group information across CRM and benefits administration systems; maintain accurate call logs and documentation. • Confirm eligibility, coverage levels, plan rules, and benefit limitations for members and providers; interpret plan documents to determine what services are covered. • Review claim adjudication outcomes, explain payment decisions, request claim adjustments, and validate supporting documentation such as EOBs, timely filing, and coordination of benefits. • Resolve member and provider questions related to benefits, claims, authorizations, billing, and network participation. • Troubleshoot issues using internal knowledge bases and system tools. • Serve as a liaison between the contact center and claims, eligibility, provider relations, and medical management teams to resolve escalated issues and ensure timely follow-through. • Maintain detailed records of all interactions, ensure HIPAA compliance, and follow established workflows and regulatory guidelines. • Assist members and providers with navigating the online portal, mobile app, coverage verification tools, and digital resources. • Conduct provider and network searches, assist with PPO and reference-based pricing networks, and guide callers in locating in-network facilities or verifying provider eligibility. • Analyze incoming requests, prep forms for scanning and routing route items to the appropriate operational teams. Fulfill faxes as needed. • Prepare routine reports, track service issues, document trends, and support operational audits or quality reviews. • Complete all assigned tasks by end of day, meet productivity and quality metrics, and support the overall efficiency of the contact center. • Identify process gaps, recommend improvements, and act as a subject matter expert to support team development and operational excellence.

🎯 Requirements

• 2+ years in a call center within a TPA, health insurer, or employee benefits environment; experience in high-volume, multi-channel operations preferred. • Familiarity with group health plans, eligibility, benefits, and claims processes. • Proficient in Microsoft Office (Word, Excel, Outlook) with the ability to quickly learn new systems, CRM tools, and workflows. • Skilled in entering and updating member/provider data, verifying information, and maintaining precise documentation. • Able to multitask, prioritize, and manage workload efficiently. • Identifies issues, evaluates information, and applies appropriate solutions. • Comfortable with changing processes, systems, and plan requirements. • Works effectively with peers and cross-functional teams.

🏖️ Benefits

• Medical • Dental • Vision • Life and Disability Insurance • Generous Paid Time Off • Tuition Reimbursement • EAP • Technology Stipend