Job Title – WCM/CCM EC/Precert Specialist
Duration – 12 months
Location – 500 Renaissance Center Detroit Michigan 48243 United States (100% remote)
Pay: $17.25
Shift: Anticipated work hours are between 8:00a.m. -5:00p.m. (overtime is not required, but will be asked on a volunteer bases; weekends are expected and include Saturday on rotation)
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
Job Type: Contract
Pay: $16.00 - $17.00 per hour
Work setting:
Experience:
- Microsoft Excel: 1 year (Preferred)
Work Location: Remote