• 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.
