Case Management Associate (Bi-Lingual) - Maternity - Remote

Overview

The Case Management Associate will assist the Case Management department in the administration of CM functions, including telephonic outreach to members and monitoring of member eligibility.

In Short

• Assist Case Managers in communication with members.
• Provide excellent customer service to callers.
• Verify member eligibility according to policies.
• Conduct outreach and follow-up calls daily.
• Document member and provider information in the database.
• Data entry into client-based systems.
• Make scripted introduction calls to Provider offices.
• Transfer clinical questions to Nurse Case Manager.
• Participate in Quality Improvement meetings.
• Protect confidentiality of member information.

Requirements

• 1 – 3 years of customer service experience in healthcare.
• High school diploma required; college degree preferred.
• Fluency in English and Spanish required.
• Call center experience preferred.
• Insurance/payor experience preferred.
• Strong verbal and written communication skills.
• Problem-solving skills with a focus on root causes.
• Proficiency in Microsoft Outlook, Excel, PowerPoint, and Word.
• Self-motivated and organized.
• Commitment to excellence in customer service.

Benefits

• 401K with company match.
• Medical and dental benefits.
• Long Term Disability.
• Paid Time Off.