[Hiring] Support Specialist-1 @HealthFirst

Role Description

The Support Specialist is responsible for assisting the primary care/case managers (PCM/CM) with non-clinical activities such as:

• Providing telephonic outreaches to members for completion of service assessments
• Outreaches to providers and community-based organizations regarding service initiation and/or continuation
• Handling member mailings
• Faxing clinical requests and approved authorized service plans

Duties and Responsibilities:

• Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests
• Review intake documents for pre-approved services and escalate discrepancies as needed
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM
• Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable
• Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances
• Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans
• Provide education to members and providers regarding requirements for approval of service requests
• Manage a large caseload while communicating member issues or needs and monitoring screening of members effectively to improve quality and cost outcomes
• Communicate with Inter/Intra-departments regarding reconciling onboarding issues
• Additional duties as assigned

Qualifications

• High School diploma or GED equivalent
• Experience in a customer service environment
• Experience working in a fast-paced environment that requires handling multiple priorities simultaneously
• Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills

Requirements

• Associate Degree/Certification in a related field (preferred)
• Knowledge of medical terminology (preferred)
• Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint (preferred)
• Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department (preferred)
• Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams (preferred)
• English proficient bilingual who also speaks Spanish, Russian, Mandarin/Cantonese, French, Haitian Creole, Korean, Bengali, Punjabi, Hindi, or Urdu (preferred)
• Demonstrated ability to document calls into a computer system (preferred)

Benefits

• Medical, dental and vision coverage
• Incentive and recognition programs
• Life insurance
• 401k contributions (subject to eligibility requirements)

Company Description

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798.

Healthfirst will never ask you for money during the recruitment or onboarding process.