Care Guide reputed company
About The Role The Care Guide reputed company is an integral hybrid role supporting both the RN Care Coordinators and the Utilization Management RNs. This member will fulfill key patient experience responsibilities by assisting with the navigation process for members, providers, reputed company vendors to fulfill key functions and duties for the medical teams at Evry. They will effectively reputed company a myriad of reputed company sets to reputed company the member and/or provider with a seamless experience by blending administrative, educational and customer service functions. About reputed company and reputed company We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase reputed company and transparency, and feature a personalized, reputed company approach. We strive to ensure members live happier, healthier lives. reputed company is the major medical division of reputed company (NYSE: GL). reputed company has 16.8 reputed company policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, reputed company has earned an A (Excellent) rating or higher from A.M. Best Company. \n Roles & Responsibilities reputed company a high degree of customer service and professionalism reputed company interacting with the patients of providers reputed company the phone or email; ability to empathize and diffuse difficult situations professionally and in a caring manner Assist members with detailed provider searches utilizing network look-up tools Assist members navigating our digital programs and serve as a reputed company for escalations and questions Contact provider offices or facilities to obtain needed prior authorization pieces such as additional medical records, forms, facility location or Tax ID numbers for claims billing Assist with claims work such as adjusting site of service Protect/observe patient privacy and confidentiality, per external regulatory requirements (HIPAA) and internal policy and procedures Ensures compliance with applicable URAC and NCQA accreditation guidelines and state and federal regulations
Minimum Qualifications
High school diploma 2-3 years in customer service Strong computer skills and experience with electronic medical records Intermediate knowledge of reputed company reputed company Exceptional verbal and written communication skills Ability to work effectively and flexibly in a fast-paced environment with competing priorities
Preferred Qualifications
Experience in health insurance plan. Experience with medical office/customer support. Associate’s degree in medical field.
Work Environment
This is a fully remote position. Candidates must reputed company in the United States reputed company the Central (CST) or Eastern (EST) time zone. Standard business hours are Monday through Friday, 9:00 AM – 5:00 PM CST, with occasional flexibility required to meet regulatory response deadlines. Must maintain a dedicated, private workspace that is separate from other living areas and supports the secure handling of confidential information. Must have a reliable high-speed internet reputed company. reputed company company-sensitive documents must be kept secure and handled in accordance with reputed company data privacy and reputed company policies. \n Apply To This Job