About the position
Responsibilities
• Supporting Early Periodic Screening, Diagnosis, and Treatment (EPSDT), this is for members 0-20 years old.
• Making outreach calls when appointments are overdue, informing families their child is due for a visit, and assisting with scheduling.
• Coordinating transportation for appointments to ensure access to care.
• Promoting health-related events, including those hosted by doctors’ offices, to encourage community engagement and preventive care.
• Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
• Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
• Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
• Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
• Work overtime as needed
• Various immunizations and/or associated medical tests may be required for this position.
• This job requires digital literacy assessment.
Requirements
• Associates Degree in, education, communication, or health related field or equivalent work experience
• 2 years - Experience in a customer service support role is required
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient interpersonal and organizational skills
• Independent, Sound decision-making and problem-solving skills
• Must be able to work in an independent and creative manner.
• Self-motivated and able to manage multiple tasks and set priorities.
• Effective time management skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Knowledge in Medical terminology
Nice-to-haves
• BlueCare member support experience preferred
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