[Hiring] Support Specialist Bilingual Mandarin Cantonese @HealthFirst

Role Description

The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as:

• Creating cases and events
• Providing telephonic outreach to members, providers, and community-based organizations
• Handling member mailings
• Faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers

The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities.

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
• English proficient bilingual who also speaks Mandarin/Cantonese
• Knowledge of medical terminology
• Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint
• Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
• Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams
• Demonstrated ability to document calls into a computer system

Benefits

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