Offer summary

Qualifications:

High School Diploma or G.E.D. is required., At least 2 years of experience in healthcare support roles such as medical assistant or office assistant., Proficiency in Microsoft Office applications., Strong customer service and communication skills..

Key responsibilities:

Perform outbound calls, emails, and process contact requests.

Support case management staff with non-clinical activities and data review.

Coordinate services according to member benefit plans and promote communication with healthcare providers.

Maintain accurate documentation and protect member confidentiality.

Job description

• Will the position be 100% remote? Yes
• Are there any specific location requirements? WASHINGTON (outside greater-Seattle)
• Are there are time zone requirements? PST
• What are the must have requirements? 2+ years of customer services experience, proficient in Microsoft office applications, comfortable being on phones.
• What are the day to day responsibilities? Outbound calls, emails, and processing of unable to contact requests.
• Is there specific licensure is required in order to qualify for the role? N/A
• What is the desired work hours (i.e. 8am – 5pm)- 8am – 5pm
• What additional equipment besides a laptop, keyboard, mouse and headset will be required for this candidate to be successful in this role? 2 monitors

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)
 Provides support to the Case Management staff performing non clinical activities and supporting the management
of the department.
 Responsible for initial review and triage of Case Management tasks.
 Reviews data to identify principle member needs and works under the direction of the Case Manager to implement
care plan.
 Screens members using Molina policies and processes assisting clinical Case Management staff as they identify
appropriate medical services
 Coordinates required services in accordance with member benefit plan.
 Promotes communication, both internally and externally to enhance effectiveness of case management services
(e.g., health care providers and health care team members).
 Runs reports to assist in coordination of case management needs.
 Provides support services to case management team members by answering telephone calls, taking messages
and researching information.
 Maintains accurate and complete documentation of required information that meets risk management, regulatory,
and accreditation requirements.
 Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job
satisfactorily)
 Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity
to concerns, proactive identification and resolution of issues to promote positive outcomes for members
 Demonstrated ability to communicate, problem solve, and work effectively with people
 Working knowledge of medical terminology and abbreviations
 Ability to think analytically and to problem solve.
 Good interpersonal/team skills
 Must have a high regard for confidential information
 Ability to work in a fast paced environment
 Able to work independently and as part of a team.
 PC experience in Windows environment and accurate data entry at 40 WPM minimum.
 Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
 Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,
providers and customers

Required Education:
High School Diploma or G.E.D.

Required Experience:
Two or more years experience as a medical assistant,
office assistant or other healthcare service administrative
support role.

Required profile