Case Resolution Specialist I

FreedomCare LLC; United States; Remote; USD 42,000 - 54,000; Full time

Benefits offered by this job

Remote work

Flexible schedule

Job summary

FreedomCare LLC is seeking a Case Resolution Specialist I to support patients and caregivers remotely, with occasional travel to the nearest hub in Pennsylvania. You will serve as the primary contact for restoring services, guide enrollment, and coordinate with health plans and providers to ensure timely authorizations.

The role emphasizes compassionate service, high-volume call handling, detailed documentation, and cross-functional collaboration to help patients resume homecare seamlessly.

Qualifications

• Experience handling high-volume inbound and outbound calls.
• Strong customer service with empathy and active listening.
• Ability to document case statuses in Salesforce.
• Proficient computer skills and fast typing.
• Prior customer service experience in a call center.
• Meet monthly metrics for starting patients on care and call handling.
• Navigate health plan portals and Medicaid processes.
• Maintain detailed patient and caregiver records.
• Communicate clearly with patients, caregivers, and health plans.
• Collaborate with Intake, Care Teams, and other departments.

Responsibilities

• Provide one-call resolution with compassionate service.
• Meet monthly performance metrics for starting patients on care.
• Be primary contact for patients and caregivers restoring services.
• Respond to emails and voicemails within one business day.
• Enroll at least 22 patients and caregivers per month in PA program.
• Maintain high-quality service on calls.
• Navigate e-Paces and health plan portals to determine eligibility and obtain authorizations.
• Maintain detailed notes.
• Assist patients? caregivers through onboarding and enrollment.
• Coordinate with health plans to ensure timely authorizations.
• Ensure documentation with PA Department of Health and insurers.
• Work cross-functionally with departments to maximize value.

Skills

High-volume calls

Customer service

Time management

Phone support

Communication

Notetaking

Multitasking

Empathy

EHR/Salesforce familiarity

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 theapplication & enrollment process of theprogram
• 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 homecareprogram
• 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 theprocess to restore services
• Communicate with patients, caregivers & health plans to ensure that theprocess 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
• Previousexperience in a Customer Service environment.
• High-volume inbound call center or contact centerenvironment (at least 2 years).
• Experience with CRMs such as Salesforce
• Ability to organize, set priorities and manage timeeffectively.
• Strong verbaland writtencommunicationskills,demonstratingactive listening and adaptability to different personalitytypes.
• Ability to resolve issues over the telephone with eager customers comfortably, defusing and de-escalation frustrated callerssuccessfully.
• Attention to detail in reviewing records.
• Ability to meet and/or exceed targets ormetrics.
• Computerproficiency 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.