Remote Customer Service Medical Rep

Job Overview

Job Description

Remote Customer Service Medical Rep needs 2 years experience in a customer service support role is required
Remote Customer Service Medical Rep requires:
Possible COVID-19 vaccine mandate.
Bilingual (Spanish)
Previous health navigation experience and medical terminology
TN, NE GA, surrounding AL locals only
Customer service support role is required
Certifications
Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
Proficient interpersonal and organizational skills
Independent, Sound decision-making and problem-solving skills
Must be able to work in an independent and creative manner.
Self-motivated and able to manage multiple tasks and set priorities.
Effective time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Knowledge in Medical terminology
Various immunizations and/or associated medical tests may be required


Remote Customer Service Medical Rep duties;
Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.
Conduct educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
Reach out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
Manage system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
Facilitate research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries
Work overtime as needed