Care Specialist-Clinical Operations
TypeFull-time job
LocationUnited States
Posted2 hours ago
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Care Specialist-Clinical OperationsJob Description:
Education:
High School Diploma or equivalent required
Experience:
A minimum 1-year experience working in an office setting as a receptionist, telephone customer service representative, or telemarketing representative required. Direct experience in a telehealth support function preferred.
Good communication skills via telephone with members, customers, peers and superiors
Mandatory Skills:
With Basic Competency Level in the ff :
Excellent interpersonal skills
Ability to understand and interpret policy provisions.
Product knowledge
Typing Skills
Problem Solving Skills
Proficient computer skills
Demonstrates empathy
With Moderate Competency Level in the ff.:
Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
Ability to assist member in navigating the healthcare system and community-based resources
Culturally sensitive and competent for assigned membership
Strong organizational skills; ability to multi-task and be nimble
Ability to work remotely
Ability to determine when to escalate issues appropriately and in a timely manner
Roles & Responsibilities:
May work in multiple products receiving inbound calls from members, physicians, clients and others to
process requests per Sagility LLC policies and guidelines
May work in multiple products conducting outbound call projects to members for enrollment purposes,
customer satisfaction surveys, and other outbound projects
Routes messages to appropriate nurse and makes pertinent notes in patient charts when necessary.
Ensures that notes are clear and timely
Uses applications according to policies and guidelines to ensure quality delivery of services.
Maintains a mutually effective working relationship with callers, physician offices, clients, team
members, supervisors, and internal customers
Maintains confidentiality of all patients according to HIPAA standards.
Collects and validates patient demographic information including insurance type and patient contact
information
Obtains pre-certification or authorization numbers if necessary for referral
Regular, reliable attendance and timeliness
Other duties as assigned
The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned
Location:
Work@Home USAUnited States of AmericaOriginally posted on Himalayas
Job title:
Care Specialist-Clinical OperationsJob Description:
Education:
High School Diploma or equivalent required
Experience:
A minimum 1-year experience working in an office setting as a receptionist, telephone customer service representative, or telemarketing representative required. Direct experience in a telehealth support function preferred.
Good communication skills via telephone with members, customers, peers and superiors
Mandatory Skills:
With Basic Competency Level in the ff :
Excellent interpersonal skills
Ability to understand and interpret policy provisions.
Product knowledge
Typing Skills
Problem Solving Skills
Proficient computer skills
Demonstrates empathy
With Moderate Competency Level in the ff.:
Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
Ability to assist member in navigating the healthcare system and community-based resources
Culturally sensitive and competent for assigned membership
Strong organizational skills; ability to multi-task and be nimble
Ability to work remotely
Ability to determine when to escalate issues appropriately and in a timely manner
Roles & Responsibilities:
May work in multiple products receiving inbound calls from members, physicians, clients and others to
process requests per Sagility LLC policies and guidelines
May work in multiple products conducting outbound call projects to members for enrollment purposes,
customer satisfaction surveys, and other outbound projects
Routes messages to appropriate nurse and makes pertinent notes in patient charts when necessary.
Ensures that notes are clear and timely
Uses applications according to policies and guidelines to ensure quality delivery of services.
Maintains a mutually effective working relationship with callers, physician offices, clients, team
members, supervisors, and internal customers
Maintains confidentiality of all patients according to HIPAA standards.
Collects and validates patient demographic information including insurance type and patient contact
information
Obtains pre-certification or authorization numbers if necessary for referral
Regular, reliable attendance and timeliness
Other duties as assigned
The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned
Location:
Work@Home USAUnited States of AmericaOriginally posted on Himalayas
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