Care Coordinator - Expert Medical Opinion

Care Coordinator - Expert Medical Opinion Chicago, Illinois, United States

Job Description

A Transcarent Care Coordinator is responsible for establishing trusting, supportive, collaborative relationships with members and their families. Coordinators build relationships with members in a clinical setting, working alongside medical providers, health coaches, nurses and behavioral health specialists in a collaborative, empathetic team.

The Care Coordinator plays a frontline role in helping members navigate barriers to care. This position ensures that members receive timely and appropriate care by assisting with provider searches, referral coordination, and communication with health plans, primary care providers, and specialty offices. The coordinator serves as a liaison between members, providers, and insurance representatives to promote a seamless care experience.

In Expert Medical Opinion, the Care Coordinator supports the consultation journey by serving as a nurse extender, taking on non-clinical and administrative responsibilities that allow RNs to focus on clinical assessment, education, and member engagement. This role helps identify and resolve non-clinical barriers to care, gathers and verifies required member information, supports medical records collection under RN direction, and assists with scheduling and coordination across internal teams.

By maintaining accurate case documentation and collaborating closely with operations and specialist partners, the Care Coordinator helps ensure cases move efficiently, and members receive timely, well-coordinated expert medical opinions.

• Answer the phone and respond to incoming inquiries with plan members to ensure understanding of the program while delivering exceptional customer service
• Work member activities via telephonic, digital messaging, and/or via external referrals to address and resolve member barriers to utilize their benefits and address program questions
• Help identify and resolve non-clinical barriers that may prevent members from utilizing their benefit and escape to RNs when clinical input is required.
• Assist clinical team members by obtaining the necessary information – demographic, financial, clinical and other pertinent data - to support members within the clinical program
• Under RN direction, initiate medical records requests, track progress, and follow up with facilities to ensure timely receipt of all required documentation
• Utilize internal platforms to provide RN and members accurate benefit, claims, and accumulator information
• Accurately record all outreach, referral status updates, and member interactions in the electronic health record (EHR) or care management system
• Partner with clinical teams, case managers, and scheduling staff to ensure members’ care plans are supported and coordinated effectively
• Demonstrate empathy, active listening, and problem-solving to promote a positive member care experience
• Assists with scheduling expert medical opinions between members and specialists, supporting both automated scheduling processes and cases requiring direct coordination.

• High School Diploma or Equivalent
• Associate’s or higher in Healthcare Administration, Public Health or related field preferred
• 1-3 Years experience in healthcare operations, telehealth, insurance claims processing, benefits processing, customer service or similar field preferred
• Highly collaborative mindset
• High level of empathy and discretion in handling sensitive medical information