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Form of workJob Description
Job Details:
- Position:Customer Service Representative (Burmese Speaking) Temp to Perm
- Remote with onsite/virtual training. Work from home position after training completion
Position Summary:
- This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services.
- Also may be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.
Essential Functions and Responsibilities:
- Meet the Department standard of calls answered, and call documentation entered.
- Assist Members and Providers with questions and concerns.
- Finding Provider(s)/Services for members
- Arrange Transportation for members
- Answer billing/claims status questions; resolve claim issues for members
- Assist with pharmacy issues
- Help Members access community support services
- Verify member eligibility
- Quote benefits
- Assist with Referrals
- Assist with member health assessments
- Assist members with closing gaps in care
- Ongoing member education.
- Responsible for all benefits information given to Members and Providers.
- Participate in Departmental Projects, as appropriate.
- Coordinate quality improvement initiatives with Medical Management, Provider Relations, and Quality Depts., i.e., Preventative Health Screenings.
- Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.
REQUIREMENTS:
- 1 Years of Experience - Required
- Needs to be Burmese speaking - Required - please notate in Profile
- High School Diploma - Required - proof not needed in submission
- 1+ year in a call center - Required
- Bilingual applicants preferred-eligible for $1 increase in pay rate
- This is a 52% markup need. Contractors need to make a facility mandated $17.00 per hour
- Candidates must reside in Michigan, Indiana, or Ohio- Required
Health system-wide profile standards
- A skills checklist completed within one year of application for RN specialties is required.
- All other professions outside of Nursing are not required but preferred.
- Michigan license verification is required for nurses. Please provide LARA and Nursys;
