Workplace Type: Onsite
Employment Type: FT
Job Location: Barberton, OH
JOB SUMMARY
The Complete Surgical Care Solution Specialist supports CHM’s cost-containment and member advocacy efforts by proactively guiding members through bundled surgical care options. This role exists to engage members early in the surgical journey, secure high-quality care at the best possible bundled rates, and coordinate seamlessly with internal teams and external partners. By serving as a knowledgeable liaison between members, CHM teams, and Coral, this position ensures a smooth, informed, and faith-centered member experience while advancing CHM’s mission of stewardship and service.
At the highest level, this role is focused on member engagement, cost-effective surgical solutions, and cross-functional collaboration that enables timely access to quality care.
PRIMARY RESPONSIBILITIES
Member Engagement & Advocacy
- Proactively engage members to assess surgical needs, explain bundled care options, and guide them through the selection process to ensure timely access to high-quality providers at optimal bundled rates.
Bundled Pricing Coordination
- Collaborate with Coral and internal CHM teams to secure, validate, and deliver bundled surgical pricing that aligns with member needs and organizational cost-containment goals.
Cross-Functional Collaboration
- Work closely with Provider Relations, Groups, and Date of Service teams to ensure accurate information flow, smooth transitions, and a seamless member experience.
Information Assessment & Documentation
- Review eligibility, medical records, and supporting documentation; identify gaps or additional requirements; and maintain accurate, organized records within CHM systems.
Member Communication & Issue Resolution
- Respond to member inquiries via phone and email, clarify treatment details and processes, and resolve concerns professionally and in a timely manner.
Process Improvement & Adaptability
- Adapt to evolving processes and initiatives, manage frequent interruptions effectively, and contribute ideas that improve efficiency, accuracy, and the overall member experience.
CORE COMPETENCIES
- Member-focused communication and service orientation
- Critical thinking and analytical problem-solving
- Medical record and workflow comprehension
- Cross-functional collaboration and coordination
- Data accuracy, documentation, and attention to detail
- Adaptability in a fast-paced, changing environment
REQUIRED QUALIFICATIONS
Education
- High school diploma or successful completion of a high school equivalency exam required.
Experience Equivalency
- Minimum of 1 year of relevant experience in Program Services or a comparable member-support, healthcare, or service-oriented environment.
- Equivalent experience demonstrating medical workflow understanding, member communication, and administrative coordination may be considered.
Certifications
- No certifications are legally required for this role.
Knowledge, Skills, & Abilities
- Demonstrated ability to communicate effectively by phone.
- Strong verbal and written communication skills for effective interaction with members and internal teams.
- Proficiency in PC operation and use of information systems and applications.
- Working knowledge of Microsoft Office (Outlook, Teams, and related tools).
- Ability to operate standard office equipment (e.g., printers, copiers, multi-line phones).
- Basic understanding of medical bills and the bill processing workflow.
- Familiarity with Date of Service processes preferred.