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We provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Support Specialist
Location
Florida
Posted
41 days ago
Salary
$34.2K - $54.6K / year
Seniority
Senior
Job Description
Support Specialist
Healthfirst
• Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests • Review intake documents for pre-approved services and escalate discrepancies as needed • Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM. • Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable • Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances • Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans • Provide education to members and providers regarding requirements for approval of service requests • Manage a large caseload while communicating member issues or needs and monitoring screening of members effectively to improve quality and cost outcomes • Communicate with Inter/Intra-departments regarding reconciling onboarding issues • Additional duties as assigned
Job Requirements
- High School diploma or GED equivalent
- Experience in a customer service environment
- Experience working in a fast-paced environment that requires handling multiple priorities simultaneously
- Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills
- Associate Degree/Certification in a related field (preferred)
- Knowledge of medical terminology (preferred)
- Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint (preferred)
- Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department (preferred)
- Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams (preferred)
- English proficient bilingual who also speaks Spanish, Russian, Mandarin/Cantonese, French, Haitian Creole, Korean, Bengali, Punjabi, Hindi, or Urdu (preferred)
Benefits
- medical, dental and vision coverage
- incentive and recognition programs
- life insurance
- 401k contributions
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