Job Description

About the Role
We are looking for a motivated and compassionate Healthcare Call Center Representative to join our team. In this role, you'll provide exceptional service to members and their legal representatives, assisting with scheduling, authorizations, and care coordination. If you enjoy engaging with others, have strong organizational skills, and thrive in a fast-paced environment, this is the perfect opportunity for you.

What You'll Do
Call Management: Handle a high volume of inbound and outbound calls, with a goal of reaching 30+ members daily.
Member Support: Speak with members and legal representatives to schedule assessments and provide updates.
Prior Authorizations: Initiate authorization requests for services in line with guidelines and resolve claims inquiries.
Care Coordination:
Verify member appointments and obtain lab results.
Monitor inpatient census and screen members for eligibility and benefits.
Refer members without a Primary Care Provider (PCP) to Member Services.
Screen and prioritize members for case management assessments.
Facilitate care transitions by contacting attending physicians, members, or authorized representatives, and coordinating with medical providers and community organizations.
Outreach and Education: Attend marketing and outreach events (as directed) and send routine letters or educational materials to members.
Data Management: Enter assessments, authorizations, and other required information into the system accurately.
What We're Looking For
Experience:
High call volume experience is preferred (comfort with handling multiple calls daily is required).
Prior appointment scheduling and customer service experience.
Skills:
Strong computer proficiency and typing skills (candidates may be asked to complete a typing test).
Bilingual (Spanish) is required for this role.
Personal Attributes:
Professional, empathetic, and organized with a commitment to member satisfaction.
Why Join Us?
This role offers the chance to make a meaningful difference in people's lives by connecting them to the care and services they need. If you're ready to bring your skills to a mission-driven team, we encourage you to apply.
Employment Type: Full-Time
Salary: $ 17.00 Per Hour

Job Tags

Hourly pay, Full time, Remote job,

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