Case Resolution Specialist I

FreedomCare LLC; Pennsylvania; Remote; USD 40,000 - 56,000; Full time

Benefits offered by this job

Medical benefits

Retirement plans

Wellness programs

Ongoing learning opportunities

Job summary

FreedomCare LLC is seeking a Case Resolution Specialist I in Pennsylvania to support patients and caregivers by coordinating intake, enrollment, and service restoration across our homecare program. This remote role requires handling high-volume calls, documenting in Salesforce, and guiding customers through application steps while maintaining compassionate, accurate service with timely follow-up.

Occasional travel to the nearest FreedomCare hub may be required, and you will be measured on call

Qualifications

• Experience in managing a high volume of inbound and outbound calls.
• Strong customer service orientation with empathy and active listening.
• Ability to document case statuses in Salesforce with clear notes.
• Proficient in using technology to resolve customer issues and multitask.
• Previous experience in a customer service environment, 2+ years preferred.
• Bilingual in Spanish is a plus.

Responsibilities

• Provide high-level customer service through one-call resolution with a helpful demeanor.
• Meet monthly metrics for starting patients on Care and call handling.
• Be primary contact for patients and caregivers restoring services and guide enrollment.
• Maintain a 1 business day response time across email, chatter, and voicemail.
• Enroll a minimum of 22 patients/caregivers monthly into PA program.
• Maintain quality customer service on inbound and outbound calls with patients/caregivers.
• Navigate systems (e-Paces, health plan portals) to determine eligibility and obtain authorization.
• Keep detailed patient and caregiver case notes and ensure paperwork is current.

Skills

Inbound/outbound calls

Customer service

Salesforce

Active listening

Time management

Typing skills

Communication skills

Multitasking

Problem solving

Bilingual (Spanish)

Tools

Salesforce

Job description

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We’re the largest consumer-directed home care agency in NY State, and are continually expanding our areas of focus including operations in other states and tech-based innovations.

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a Case Resolution Specialist I for our team in Pennsylvania.

This is a remote role with occasional travel into the FreedomCare hub closest to you.

Department & Position Overview:

The Case Resolution Specialist I role is a customer-centric role will partner with patients and health plans to identify issues preventing the patient from continuing services. This team also assists any former patient who is looking to return to the agency with restoring their homecare services. This role combines the intake and onboarding activities for both patients and caregivers and provides one point of contact consumer experience in their transition back our program.

Responsibilities:

• Provide high-level customer service through one-call resolution, as measured by “no need for additional follow up” demonstrating Freedom Care's values of ensuring care and compassion with a positive, helpful demeanor
• Consistently meets monthly performance metrics of starting patients on Care and call handling
• Act as the primary point of contact for all Patients and Caregivers restoring their services, coaching them through the application & enrollment process of the program
• Demonstrate effective case management by maintaining a 1 business day email, chatter and voicemail response time
• Achieve monthly standard to enroll a minimum of 22 patients and caregivers onto FreedomCare’s Pennsylvania homecare program
• Maintain high quality of customer service on all inbound & outbound calls with potential patients & caregivers
• Navigate multiple systems, such as e-Paces & health plan portals to determine eligibility and obtain authorization
• Maintain detailed patient and caregiver case notes
• Focus on the growth of FreedomCare population by enrolling each valid lead with interest
• Align consumers with caregivers looking for additional hours
• Assist both patients & caregivers with completing the process to restore services
• Communicate with patients, caregivers & health plans to ensure that the process is completed
• Consistently reach out to patients to provide updates and ensure that they are aware of the status of the process
• Work cross-functionally with Intake, Care Teams, and all other necessary departments to ensure that patients/caregivers are engaged and getting the most value out of our services
• Meet daily, weekly & monthly metrics & call requirements to ensure patients can resume services
• Assist patients with troubleshooting & resolving any Medicaid related issues.
• Educate patients & caregivers about the onboarding process
• Work with health plans to obtain authorizations & ensure all necessary paperwork is on file & up to date
• Provides necessary documentation and requirements with Pennsylvania's State Department of Health, patients' insurance and the Patient’s Caregivers to ensure services are authorized in a quick and efficient turn-around time to get them on Care
• Work with other medical providers to ensure all documentation for potential patients and caregivers is in compliance

Ideal Candidate Will Possess:

• Experience in managing a high volume of inbound and outbound calls
• A passion for providing a high level of customer service, including the ability to show empathy, active listening and patience
• Ability to articulate case statuses through detailed notes on salesforce
• Computer proficiency required; strong typing skills and ability to leverage technology and resolve customer issues
• Previous experience in a Customer Service environment.
• High-volume inbound call center or contact center environment (at least 2 years).
• Experience with CRMs such as Salesforce
• Ability to organize, set priorities and manage time effectively.
• Strong verbal and written communication skills, demonstrating active listening and adaptability to different personality types.
• Ability to resolve issues over the telephone with eager customers comfortably, defusing and de-escalation frustrated callers successfully.
• Attention to detail in reviewing records.
• Ability to meet and/or exceed targets or metrics.
• Computer proficiency required; strong typing skills and ability to leverage technology and resolve customer issues efficiently while notetaking/multitasking

Nice-to-Haves:

• 2 years of relevant experience in a similar position is preferred
• Bilingual in Spanish, or other languages desired
• Salesforce proficiency
• Familiarity with Pennsylvania Medicaid & health plan experience

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, citizenship or immigration status, or other applicable legally protected characteristics.