Contract Customer Care Specialists POST NUMBER: 479754
Location: Miramar, FL
Compensation: $20/hour
Schedule: Monday-Friday 9AM-6PM
Overview:
The Customer Care Specialist plays a critical role in coordinating healthcare services, ensuring timely delivery of approved services and items for patients. This multi-faceted position involves daily interactions with patients, healthcare providers, home health agencies, durable medical equipment (DME) providers, and health plans. The specialist serves as a key liaison, facilitating smooth transitions of care while maintaining compliance with regulatory requirements. Success in this role requires excellent communication, problem-solving, and organizational skills to enhance service delivery and patient satisfaction.
Key duties / responsibilities / accountabilities, and other duties as assigned/required:
Patient & Provider Coordination:
- Act as the primary liaison between patients, providers, and health plans to address and resolve service-related issues.
- Facilitate the timely scheduling and delivery of authorized services, ensuring high-quality patient care.
- Maintain effective communication with providers to ensure compliance with network standards and service expectations.
- Handle inbound calls, chat messages, and emails, providing prompt and professional support.
- Manage customer service calls transferred to the department for resolution.
- Conduct outbound calls to patients and providers to confirm service delivery and resolve any delays.
- Address patient concerns in a courteous, professional, and timely manner.
Ensure all referral documentation is accurate, complete, and properly recorded in relevant systems.
Resolve referral-related issues, including provider availability, authorization delays, and patient escalations.
Assist in identifying providers across regions or markets with the capacity to meet patient needs.
Provider & Health Plan Relations:
- Maintain and strengthen relationships with network providers and health plan partners.
- Support the Provider Network Department in negotiating Letters of Agreement (LOA) or Single Case Agreements (SCA) when necessary.
- Serve as a resource for providers, health plans, and internal staff while supporting the Utilization Management Program.
- Ensure confidentiality and compliance with HIPAA, CMS, NCQA, and company policies.
- Participate in performance improvement initiatives, committee meetings, and training activities to support quality improvement efforts.
- Investigate claim denials or payment discrepancies related to referral errors, missing authorizations, or incorrect documentation.
- Collaborate with the claims processing team to resolve referral-related issues before adjudication.
- Maintain thorough and accurate documentation of patient interactions and service confirmations.
- Escalate service delays or concerns to the appropriate department for resolution.
- Participate in team meetings, training sessions, and after-hours/on-call support as scheduled.
- Perform other duties as assigned to support department operations.
Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.
EEO Notice
Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.
Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact HR@vaco.com .
Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.
By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.
Privacy Notice
Vaco by Highspring and its parents, affiliates, and subsidiaries (“we,” “our,” or “Vaco by Highspring”) respects your privacy and are committed to providing transparent notice of our policies.
- California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here.
- Virginia residents may access our state specific policies here.
- Residents of all other states may access our policies here.
- Canadian residents may access our policies in English here and in French here.
- Residents of countries governed by GDPR may access our policies here.
Pay Transparency Notice
Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to:
- the individual’s skill sets, experience and training;
- licensure and certification requirements;
- office location and other geographic considerations;
- other business and organizational needs.
With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.