- Respond to incoming inquiries from patients, healthcare providers, internal teams, and other stakeholders.
- Assist patients with inquiries related to medical benefits, claims, and coverage.
- Provide guidance and assistance to patients in navigating complex medical services and treatments.
- Coordinate patient referrals with external healthcare providers and platforms.
- Interpret and utilize medical plan documentation to address patient queries effectively.
- Liaise with vendor partners to address patient needs and concerns.
- Aid patients in identifying and accessing high-quality, cost-effective medical services.
- Collaborate with various departments to resolve intricate patient issues.
- Escalate challenging cases to management or clinical teams as necessary.
- Accurately document all patient interactions and calls in the system.
- Participate in continuous training to stay updated on medical regulations and company protocols.
- Collaborate on internal projects as assigned.
- Contribute to the development of internal and external medical content.
- Facilitate patient travel arrangements as required.
- Preferably holds a Bachelor's degree in healthcare, social work, or a related field; however, it's not mandatory.
- Minimum of 1 year of experience in a healthcare customer service position, ideally in a challenging setting.
- Exceptional verbal and written communication abilities.
- Demonstrates resourcefulness and quick thinking in dynamic environments.
- Capable of efficiently managing high call volumes.
- Displays meticulous attention to detail and ensures accurate and comprehensive documentation.
- Exhibits empathy and compassion in all customer interactions.
- Equipped for remote work with a stable high-speed internet connection and a dedicated, distraction-free workspace.
- Occasionally available for in-office meetings at our Round Rock, Texas location.
- Familiarity with medical terminology and proficiency in advanced health insurance concepts.
- Competence in Microsoft Office and adept with computer systems.
- Fluency in spoken and written Spanish is advantageous.
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Health Care Member Advocate - Austin, United States - Ultimate Staffing Services
Description
Job Description
Job DescriptionDuties and Responsibilities:
Requirements:
All qualified applicants will receive consideration for employment without regard torace, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status.We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.