Sr Project Coordinator - Sales Complaint Investigations Coordinator

Health Care Service Corporation
life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, 401(k)
United States, Tennessee, Nashville
Jul 23, 2025
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary - Responsible for researching and/or investigating complex sales related complaints. - Responsible for assigned caseload which requires timely follow up to ensure completion of cases within tight frames in order to meet internal and CMS expected goals. - Demonstrates the ability to problem solve, identify root causes and make the proper recommendations to correct the root cause of the issue/complaint. - Makes outbound calls to gather information and/or communicate the resolution to the appropriated party regarding the member complaint. - Creates written correspondence letters to provide resolution to complaints when verbal contact cannot be made with the complainant. - Documents all case research notes and resolution actions, in the appropriate systems, within the required timeframes. - Communicates with other departments, when necessary, to resolve member issues. - Manage, process, and document cases for the Sales Development Action Program (SDAP) and committees. The research findings are presented to the committee. - Involved in routine oversight and ad hoc duties for the SDAP and Complaint Investigation Process - Responsible for sales support processes, including but not limited to complaint creation and submission, complaint tracking and reporting, CRM database updates and/or general sales support. - Conduct a thorough investigation of complaints (CTMs, CSVs, etc.) and escalated inquiries from customers that complained to CMS, the local department of insurance, Customer Service, etc. - Subject matter expert for complaint related issues for both internal and external partners including Sales, Sales Operations, Sales Account Management, CARL Escalations, or Broker Strategist teams. - Serve as resource for compliance-related issues and reporting - Perform quality checks to ensure compliance with CMS policies and procedures - Perform ad hoc audits and projects for the department outside of normal duties Required Job Qualifications: Bachelor's degree and 3 years of business, training or project management experience OR 7 years of business, training, or project management experience. Experience defining business requirements for new systems or changes to existing systems and processes. Experience leading an assigned phase of a large-scale project or leading all phases or a small or medium project. Experience facilitating groups and delivering presentations. Knowledge of operational areas in a health care environment. Knowledge of various corporate systems applications. Clear and concise interpersonal, verbal, and written communication skills. PC experience to include Word, Excel, and PowerPoint Preferred Job Qualifications: Experience in technical training Experience resolving complex membership transactions and inquiries Call Center knowledge and experience including ACE, BAE, and Billing Demonstrate a vision for the future, positive advocate for vendor partners Advanced level Excel, PPT and Access skills Working knowledge of Salesforce/GEMS applications BlueSTAR Member Maintenance & AEP processing experience Strong problem-solving skills, which include the ability to factor in risks and understand the potential impact of particular actions to internal/external customers Knowledge of sales and marketing operations Claims processing knowledge This is a Flex (Hybrid) role: 3 days in office; 2 days remote. #LI-MW2 #LI-Hybrid Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range$54,800.00 - $121,100.00