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    Precertification Specialist - Detroit, United States - G-TECH

    G-TECH
    G-TECH Detroit, United States

    5 days ago

    Default job background
    Description
    Required Skills and Experience:

    Medical Terminology or medical background such as nursing assistant/tech or doctor office experience

    Formal education past high school

    Customer Service experience

    Exceptional phone skills

    Administrative/PC skills

    Highly preferred:
    • Provide high quality, member focused servicing using knowledge of plans, products, systems, and procedures to meet or exceed member experience
    • Assist in locating primary care physicians,specialists and dentists
    • Thoroughly explain wellness care management program benefits to members
    • Work as a team member to assist nurses in researching providers, eldercare, nursing homes
    • Concisely and accurately enter documentation into Care Advance
    • Effectively engage over the phone via both inbound and outbound members that qualify for our clinical programs or those who are interested in learning more about our services
    • Refer and/or warm transfer to wellness and care management components and other BCBSM areas and vendors as needed
    • Process provider requests as needed
    • Act as member first trusted source for WCM programs
    • Schedule appointments between the member and coach in appropriate systems
    • Assign referrals to designated staff
    • Process requests for compliance inquiries
    • Access various WCM department mailboxes and voicemail as needed
    Ability to function independently.

    Critical Thinking

    Quick learner

    Category Clerical

    Function Clerical / Administrative

    Req ID JN
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