- RESPONSIBILITIES:
- Anticipated work hours are between 8:00a.m. - 8:00p.m. (Rotating Saturdays, holidays, and overtime as needed)
- 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 areas of Our Client and its vendors as needed
- Process provider requests as needed
- Act as member's 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
- Required Skills and Experience:
- Medical Terminology or medical background such as nursing assistant/tech or doctor office experience
- Customer Service experience
- Exceptional phone skills
- Administrative/PC skills
Precertification Specialist - Michigan, United States - OpTech
Description
QUALIFICATIONS: