Support Specialist

HealthFirst; United States; Remote; USD 35,000 - 55,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

401(k) plan

Incentive programs

Life insurance

Job summary

HealthFirst is seeking a Support Coordinator to assist care/case managers with non-clinical activities, including creating cases, telephonic outreach, and processing authorizations and care plans. You will work with care teams and providers to support member services and outcomes.

The role requires strong communication, multitasking, and knowledge of health plan processes. We offer competitive benefits and a collaborative environment in a values-driven organization.

Qualifications

• High School diploma or GED equivalent.
• Experience in a customer service environment.
• Experience in fast-paced environment with multiple priorities.
• Strong written and verbal communication with good grammar.

Responsibilities

• Conduct outreaches for newly enrolled members to review current and approved services, DME and additional requests.
• Review intake documents for pre-approved services and elevate discrepancies as needed.
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify issues needing clinical escalation.
• Initiate and finalize authorization in Trucare for preapproved services and DMEs and update/discontinue authorizations as applicable.
• Handle and document calls to/from members regarding benefit questions/issues, scheduling, assessments, service issues and grievances.
• Handle and document calls to/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/needs and monitoring screening to improve outcomes.
• Communicate with Inter/Intra-departments regarding onboarding issues.
• Additional duties as assigned.

Skills

Customer service

Communication skills

Multitasking

Verbal communication

Office software

Education

High School diploma or GED

Associate degree/certification in related field

Tools

Trucare

Salesforce

HHAXchange

DocuSign Epaces

Sharepoint

Job 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 elevate 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

Minimum 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

Preferred Qualifications:

• Associate Degree/Certification in a related field
• 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
• English proficient bilingual who also speaks Spanish or Mandarin/Cantonese
• Demonstrated ability to document calls into a computer system

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $40,200 - $54,570
• All Other Locations (within approved locations): $34,900 - $52,000

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.