Medicare Advantage Provider Call Center Support Specialist - Remote

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position supports administrative care management duties including member and provider outreach, supporting healthcare initiatives and activities including educational and quality campaigns, assistance in scheduling care manager and member appointments, responding to member inquiries, data entry and research, supporting member non-clinical needs. This position may be responsible to manage low-risk members for health-related social needs, education, and basic member outreach screenings/inquiries. Key Responsibilities include handling a high volume of inbound calls seeking pre-authorization or other determining authorization requirements. JOB REQUIREMENTS:

• High school diploma or GED
• 1 year of college and 2 years experience with communication systems including Fax, Email and Telephone
• 1 year experience with managed care system(s) or healthcare systems (i.e.; hospital ,doctor office, community based organization).
• Experience coordinating member needs, providing assistance to members, and analyzing member needs.
• Basic knowledge of medical or healthcare terminology.
• Knowledge of clinical systems (claims, enrollment, documentation).
• PC proficiency including Microsoft Office applications.
• Customer service skills.
• Verbal and written communications skills including developing written correspondence to internal and external stakeholders.

PREFERRED JOB REQUIREMENTS:

• College courses in medical field, human services, social work, psychology or related healthcare field related
• Call Center Experience preferred
• Experience with CMS guidelines preferred
• Experience with precertification systems, including MHK, FACETS and/or QNXT strongly preferred
• Experience with Verint and Finesse strongly preferred

Additional Work Details:

• Work Schedule: Any 8-hour shift during business hours of Monday - Friday, 7am CST - 7pm CST
• Telecommute: This is a Telecommute (Remote) role: Must reside within 250 miles of the offices locations listed or anywhere within the posted state.
• Must be able to hard-wire internet connection

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range$17.75 - $27.83 Apply Job! Apply to this Job