JOB SUMMARY

• The Compliance Deliverables Data Coordinator at Community Health Choice is a critical role involving handling reporting and deliverables for complaints and grievances from members and providers.
• Overseeing maintenance and data accuracy of required Medicaid, Medicare, and Marketplace Complaint Logs, continually working with team members to maintain log, the ability to input and pull data for trending as needed, and the ability to maintain reporting for regulatory bodies, HHSC, TDI and CMS.
• This position requires a high level of attention to detail, knowledge of complaint resolution processes across various lines of business, and excellent reporting and customer service skills.

JOB SPECIFICATIONS AND CORE COMPETENCIES

• Data entry for compliance deliverables, overseeing maintenance of required Medicaid, Medicare, and Marketplace Complaint logs.
• Generating monthly reports for state and federal entities.
• Handling and resolving member and provider complaints and grievances.
• Collaborating with internal teams to ensure compliance with regulations.
• Providing excellent customer service to members and providers.
• Maintaining a high level of accuracy in all compliance-related tasks.
• Other duties as assigned.

QUALIFICATIONS:

• Education/Specialized Training/Licensure: High School Diploma or GED
• Bachelors degree
• Work Experience (Years and Area): 3+ years of work experience, with expertise in data entry, generating monthly reports for state and federal entities.
• Software Proficiencies: Microsoft Office, QNXT, OICS, Salesforce, Teams, PowerPoint, Advanced Excel Skills
• Other: MDS