Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
The Inbound Queue Associate - Behavioral Health role is responsible for accepting inbound calls from facilities, providers, and members regarding pre-certification process within Medicare and Commercial Insurance.
Responsibilities include:
- Performing intake of calls from members or providers regarding services via telephone, fax, EDI
- Screening requests for appropriate referral to medical services staff
- Approving services that do not require a medical review in accordance with the benefit plan
- Conducting non-medical research including eligibility verification, COB, and benefits verification
- Maintaining accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
- Protecting the confidentiality of member information and adhering to company policies regarding confidentiality
- Communicating with Aetna Case Managers, when processing transactions for members active in this program
Requirements:
- 1+ years of Customer Service Background
- 1+ years of Call Center experience
- High-speed internet and a secure working space
Preferred qualifications:
- Familiarity with basic medical terminology and concepts used in care management
- 2-4 years experience as a medical assistant, office assistant or other clinical experience
- Effective communication, telephonic and organization skills
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members
- Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word
- Ability to effectively participate in a multi-disciplinary team including internal and external participants
Education:
- High School Diploma or equivalent GED
Benefits:
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
Salary: $17.00 - $28.46 per hour