Job Details

• Title (Implied): Medical Services Coordinator / LTSS Intake Coordinator

• Location: Fully remote (never onsite)

• Schedule: Monday to Friday, 8am–5pm EST

• Time Zones Accepted: EST or CST (must work EST hours)

• Industry: Healthcare (insurance/managed care)

Key Responsibilities

• Handle intake of calls from members or providers (phone, fax, EDI)

• Use internal systems (Profax, Dynamo, QNXT) to build LTSS (Long-Term Services and Supports) cases

• Screen and triage referrals for medical service review

• Approve non-medical services per benefit guidelines

• Conduct eligibility and benefits verification

• Support case managers with documentation, outreach, and coordination

• Make outbound calls to providers for information

• Ensure compliance with standards (NCQA, URAC, HIPAA)

• Accurately document all activity in systems

• Perform all work from a home office setup

Qualifications

• Education: High School Diploma or GED (required)

• Experience:

  • 1–3 years of call center experience preferred

  • Familiarity with medical terminology and care coordination

  • Customer service skills essential

  • Comfortable using Microsoft Office and healthcare systems

Tools & Systems You’ll Use

• Profax, Dynamo, QNXT

• Microsoft Word & Excel

• Telephonic systems and electronic documentation

Ideal Candidate Traits

• Comfortable with high-volume calls and data entry

• Able to multitask in a fast-paced environment

• Highly detail-oriented

• Strong communication and team collaboration skills

• Familiar with insurance verification and prior authorization workflows