Job Summary:

Reports to direct superior and works closely with other GMMI departments to manage daily tasks related to active and past cases of assigned clients according to Client Specific Procedures. Responsible for cohesiveness, efficiency and quality assurance of procedures for assigned clients.

Principal Duties and Responsibilities:

• Communicates with clients, patients and providers
• Handles incoming Assistance Coordinator Team calls / acts as Assistance Coordinator as needed
• Ensures that active cases on the case log are worked and followed up according to Client Specific Procedures
• Deletes completed or non-active cases on a regular basis to maintain a clean case log
• Has extended knowledge of all assigned clients policies and procedures
• Has basic knowledge of client procedures on all other GMMI clients
• Runs client reports on a daily and monthly basis or as requested by Management
• Extended knowledge of medical bill screen
• Ensures that inquiries are handled according to GMMI’s Quality Policy Guidelines
• Follows up on bills on hold on a regular basis in order to ensure that claims are processed in a timely manner according to GMMI’s Quality Policy Guidelines
• Collaboration and communication with Assistance Department to ensure that all Client cases are handled according to GMMI’s Quality Policy Guidelines and Client requirements
• Basic knowledge of claims processing
• Ability to handle urgent balance bills and statements received from Clients and insured
• Handles complicated issues and matters from providers and insured and may seek assistance from Account Manager and/or direct Supervisor to resolve it
• Assures that account adjustments are current and performed in accordance with GMMI policy (i.e. credit memos)
• Trains Assistance Coordinators and Claims staff related to Client Specific Procedures and Policies upon request
• Handles any other tasks as requested by Management

Required / Desired Knowledge, Experiences and Skills:

• Knowledge and experience in the healthcare and insurance industry
• Proficient in GMMI policies and procedures
• Proficient in GMMI claims processing and reporting
• Excellent verbal and written communication skills and ability to manage and prioritize multiple tasks. Multilingual with excellent English language skills
• Excellent interpersonal skills necessary to interact positively with clients, providers and professional staff. Must represent the organization in a professional and knowledgeable manner
• Computer skills essential to manage correspondence, database maintenance, spreadsheet analysis and for information entry / retrieval from the company’s internal operating system
• Prior experience as Assistance Coordinator (former Customer Service Representative)
• Knowledge of “GMMI Online”
• Basic knowledge of medical terminology and the US healthcare system

Education/Certifications:

• High School Diploma or Equivalent (GED) required

Physical Working Environment:

While performing the duties of this job, the employee is required to stand; walk; sit for long periods of time; use of hands to grasp, handle, or feel; reach with hands and arms; finger dexterity; talk; hear. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

The above statements are intended to describe the general nature of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties and skills required of employees so classified.

GMMI is an Equal Opportunity Employer M/F/Disability/Veteran