Clerical Support Coordinator

Position Summary

The Clerical Coordinator supports the contact center by combining administrative accuracy with strong customer service. This role manages high-volume inquiries, maintains detailed records, processes requests, and ensures smooth workflow across departments. Acting as a liaison between frontline staff and internal teams, the coordinator ensures timely resolution of issues, accurate documentation, and efficient back-office operations that enhance overall service quality.

Essential Functions

• Manage high volumes of inbound and outbound member and provider calls, CRM-routed requests, emails, and digital submissions; validate account and eligibility details; and document all interactions and actions taken in accordance with internal quality standards.
• Enter, update, and verify member, provider, and employer-group information across CRM and benefits administration systems; maintain accurate call logs and documentation.
• Confirm eligibility, coverage levels, plan rules, and benefit limitations for members and providers; interpret plan documents to determine what services are covered.
• Review claim adjudication outcomes, explain payment decisions, request claim adjustments, and validate supporting documentation such as EOBs, timely filing, and coordination of benefits.
• Resolve member and provider questions related to benefits, claims, authorizations, billing, and network participation.
• Troubleshoot issues using internal knowledge bases and system tools.
• Serve as a liaison between the contact center and claims, eligibility, provider relations, and medical management teams to resolve escalated issues and ensure timely follow-through.
• Maintain detailed records of all interactions, ensure HIPAA compliance, and follow established workflows and regulatory guidelines.
• Absorb and respond to member and provider inquiries about the online portal, mobile app, coverage verification tools, and digital resources.
• Conduct provider and network searches, assist with PPO and reference-based pricing networks, and guide callers in locating in-network facilities or verifying provider eligibility.
• Analyze incoming requests, prep forms for scanning and routing, route items to the appropriate operational teams, and fulfill faxes as needed.
• Prepare routine reports, track service issues, document trends, and support operational audits or quality reviews.
• Complete all assigned tasks by end of day, meet productivity and quality metrics, and support the overall efficiency of the contact center.
• Identify process gaps, recommend improvements, and act as a subject matter expert to support team development and operational excellence.

Education and Skills

• High School Diploma or equivalent work experience required.
• Experience and skills: 2+ years in a call center within a TPA, health insurer, or employee benefits environment; experience in high-volume, multi-channel operations preferred. Familiarity with group health plans, eligibility, benefits, and claims processes. Proficient in Microsoft Office (Word, Excel, Outlook) with the ability to quickly learn new systems, CRM tools, and workflows. Skilled in entering and updating member/provider data, verifying information, and maintaining precise documentation. Able to multitask, prioritize, and manage workload efficiently. Identifies issues, evaluates information, and applies appropriate solutions. Comfortable with changing processes, systems, and plan requirements. Works effectively with peers and cross-functional teams.

Physical Demands and Work Environment

• This is a standard desk role requiring extended sitting and computer work.
• Work environment: Remote.

Additional Information

• Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
• Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.
• It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.