Military Spouse Connection Jobs

Duties and Responsibilities:

Provides excellent quality customer service to our members and/or providers relating to questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention

Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans

Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Care Managers

Manages a large member caseload

Meets/Exceeds all performance KPIs including but not limited to quality and productivity

Builds sustainable relationships of trust through open and interactive communication with internal and external customers

Documents accurate member information in compliance with our internal procedures

Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately

Timely communicates member issues or needs and monitors screening of members effectively to improve quality and cost outcomes

Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines

Additional duties as assigned

Minimum Qualifications:

High School diploma or GED from an accredited institution

Prior experience in a customer service environment

Working experience in a fast-paced environment

Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook

Preferred Qualifications:

Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese.

Knowledge of medical terminology

Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department

Experience navigating multiple technologies including a Customer Relationship Management System (i.e., locate information, route future actions, notate resolutions, update member information, etc.)

Proven track record of exercising independent thinking, problem solving and achieving goals

Excellent verbal and written communication and the ability to document grammatically correct emails, communications, and presentations

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.