Two Chicks With A Side Hustle

Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.

JOB DESCRIPTION:

JOB RESPONSIBILITIES

  • Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
  • Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
  • Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
  • Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
  • Work overtime as needed
  • Various immunizations and/or associated medical tests may be required for this position.
  • This job requires digital literacy assessment.

JOB QUALIFICATIONS

Education

  • Associates Degree in, education, communication, or health related field or equivalent work experience

Experience

  • 2 years – Experience in a customer service support role is required

Skills\Certifications

  • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
  • Proficient interpersonal and organizational skills
  • Independent, Sound decision-making and problem-solving skills
  • Must be able to work in an independent and creative manner.
  • Self-motivated and able to manage multiple tasks and set priorities.
  • Effective time management skills
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational skills
  • Knowledge in Medical terminology

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