Care Coordination & Member Support Specialist

Healthcare Support Staffing; Pittsburgh (Allegheny County); On-site; USD 38,000 - 46,000; Full time

Benefits offered by this job

Fun and positive work environment

Opportunity for growth and advancement

Job summary

HealthCare Support Staffing, Inc. (HSS) is seeking a healthcare support professional to handle member and provider calls, collaborate with the care management team, and help ensure members receive proper care.

You will use computer systems during calls, perform eligibility checks, coordinate services with providers and community resources, and support transition of care activities to improve outcomes. Join a fast-paced environment with opportunities for growth and contribute to high-quality

Qualifications

• High school diploma.
• 1-2+ years of healthcare experience.
• 1-2+ years of call center experience.
• Understanding of medical terminology.
• Ability to work in a fast-paced call center.

Responsibilities

• Take calls from members and providers.
• Work closely with the care management team to ensure members are receiving proper care.
• Enter assessments and authorizations into the system while talking to members.
• Screen for eligibility and benefits as part of the workflow.
• Coordinate services with community-based organizations and other providers.

Skills

Healthcare experience

Call center experience

Medical terminology

Adaptability

Education

High school diploma

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Company Job Description/Day to Day Duties:

• Will be taking calls from members and providers.
• Will work closely with the care management team to ensure members are receiving proper care
• Will be working on the computer as they talk to members to set them up in the system.
• Taking calls from members and providers to ensure members are receiving proper care
  
• Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.
• Initiate authorization requests for output or input services in keeping with the prior authorization list.
• Research claim inquiries specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments and obtaining lab results.
• Screen for eligibility and benefits.
• Screen members by priority for case management assessments.
• Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
• Coordinate services with community based organizations.
• Produces and mails routine Case Management letters and program educational material.
• Enter assessments and authorizations into the system.

Shift: Monday-Friday, 8:00am-5:30pm

Advantages of this Opportunity:

• Fun and positive work environment
• Opportunity for growth and advancement!

Qualifications

Requirements:

• High school diploma
• 1-2+ years of healthcare experience
• 1-2+ years of call center experience
• Understanding of medical terminology
  
• Ability to work in a fast-paced call center
  

Additional Information

Interested in hearing more about this great opportunity? Please click Apply or call Laura Cornelius at 407-478-0332 ext 107

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