Coordinator, Individualized Care

**Key Responsibilities**

+ Process enrollment requests and create complete, accurate case records to support timely downstream claim support activity.
+ First line team member to identifying Adverse Events
+ Complete Tier 1 claim reviews using program business rules, identifying missing information, obvious coding or submission issues, and the next best action for the provider.
+ Conduct benefit verification and basic payer outreach activities, as assigned, to confirm coverage requirements or obtain clarification needed to move cases forward.
+ Document all actions, outcomes, and communications clearly in the program CRM to ensure continuity and visibility across teams.
+ Identify cases that require higher level review and route or escalate to the appropriate US Case Manager, Supervisor, or program leadership per defined workflows.
+ Support seasonal surge readiness by maintaining queue discipline, meeting turnaround expectations, and flexing assignments base...