Care Specialist-Clinical Operations

Sagility India Private Ltd; El Paso (TX); Remote; USD 36.000 - 48.000; Vollzeit

Zusammenfassung

Sagility India Private Ltd seeks a Care Specialist-Clinical Operations to support members via phone, assist with enrollment and surveys, and coordinate with clinical teams. You will document interactions, protect patient confidentiality, and help navigate the healthcare system.

This is a remote position requiring excellent communication and multitasking abilities. Candidates should have at least 1 year in an office-reception or call-center role, with a preference for telehealth exposure.

Qualifikationen

• High School Diploma or equivalent required.
• 1+ year office experience (receptionist, telephone customer service or telemarketing) required; telehealth support preferred.

Aufgaben

• Handle inbound calls from members, physicians, clients and others per Sagility policies/guidelines.
• Conduct outbound calls for enrollment, member surveys and other projects.
• Route messages to nurse and document notes in patient charts when needed.
• Maintain timely, clear notes and use applications per policy to ensure quality service.
• Maintain confidentiality of all patients per HIPAA standards.

Kenntnisse

Excellent interpersonal skills

Policy interpretation

Product knowledge

Typing skills

Problem solving

Proficient computer skills

Empathy

Member advocacy

Navigate healthcare system

Cultural sensitivity

Multitasking

Remote work capability

Issue escalation

Ausbildung

High School Diploma or equivalent

Jobbeschreibung

Job title

Care Specialist-Clinical Operations

About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title

Care Specialist-Clinical Operations

Job Description

Education

High School Diploma or equivalent required

Experience

• A minimum 1-year experience working in an office setting as a receptionist, telephone customer service representative, or telemarketing representative required. Direct experience in a telehealth support function preferred.
• Good communication skills via telephone with members, customers, peers and superiors

Mandatory Skills

• With Basic Competency Level in the ff :
• Excellent interpersonal skills
• Ability to understand and interpret policy provisions.
• Product knowledge
• Typing Skills
• Problem Solving Skills
• Proficient computer skills
• Demonstrates empathy
• With Moderate Competency Level in the ff.:
• Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
• Ability to assist member in navigating the healthcare system and community-based resources
• Culturally sensitive and competent for assigned membership
• Strong organizational skills; ability to multi-task and be nimble
• Ability to work remotely
• Ability to determine when to escape issues appropriately and in a timely manner

Roles & Responsibilities

• May work in multiple products receiving inbound calls from members, physicians, clients and others to
• process requests per Sagility LLC policies and guidelines
• May work in multiple products conducting outbound call projects to members for enrollment purposes,
• customer satisfaction surveys, and other outbound projects
• Routes messages to appropriate nurse and makes pertinent notes in patient charts when necessary.
• Ensures that notes are clear and timely
• Uses applications according to policies and guidelines to ensure quality delivery of services.
• Maintains a mutually effective working relationship with callers, physician offices, clients, team
• members, supervisors, and internal customers
• Maintains confidentiality of all patients according to HIPAA standards.
• Collects and validates patient demographic information including insurance type and patient contact
• information
• Obtains pre-certification or authorization numbers if necessary for referral
• Regular, reliable attendance and timeliness
• Other duties as assigned

The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned

Location

Work@Home USAUnited States of America