Client Services Coordinator 2, Quality Department

Job overview

The Client Services Coordinator 2, Quality Department role is listed in 00926, Puerto Rico. Compensation is not specified. The position is dedicated to APS Health Care PR’s Quality Department and serves members, providers, facilities, and clinical and operational staff. The coordinator manages complaint, grievance, and appeal processes, investigates concerns, maintains records, and monitors required notifications. The role supports timely, compliant service while limiting clinical data work to activities that do not require interpretation of clinical information.

What you'll do

• Comply with applicable CMS and other regulatory guidelines
• recognize client needs related to complaints, grievances, and appeals
• receive, prepare, manage, and investigate case files
• maintain records and databases
• send required letters and monitor notification deadlines
• collect and transfer non-clinical data and review service requests for completeness
• perform other assigned duties.

What we're looking for

Skills & competencies

client services coordinator 2

quality department

aps health care pr

00926 puerto rico

full-time

customer service

complaints

grievances

appeals

case documentation

cms guidelines

microsoft office

Work arrangement

• Weekend coverage required

Why this role

High school diploma required; bachelor’s degree preferred; at least two years of customer service experience required.

About the employer

APS Health Care PR is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.