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

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 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

Bi-Lingual/Spanish

Category Clerical

Function Clerical / Administrative

Req ID JN -062024-121308