WCM CCM EC Precert Specialist Apply
Overview:
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.
Title: WCM/CCM EC/Precert Specialist
Work Location: Detroit, MI 48243
Duration: 12 Months
Job Type: Contract
Work Type: Remote
Dept: Commercial Inpatient Pr
Job Description
Engagement Description
Required Skills and Experience:
- Medical Terminology or medical background such as nursing assistant/tech or doctor office experience
- Customer Service experience
- Exceptional phone skills
- Administrative/PC skills
Highly preferred:
- Provide high quality, member focused servicing using knowledge of plans, products, systems, and procedures to meet or exceed member experience
- Assist in locating primary care physicians,specialists and dentists
- Thoroughly explain wellness care management program benefits to members
- Work as a team member to assist nurses in researching providers, eldercare, nursing homes
- Concisely and accurately enter documentation into Care Advance\
- Effectively engage over the phone via both inbound and outbound members that qualify for our clinical programs or those who are interested in learning more about our services
- Refer and/or warm transfer to wellness and care management components and other Client areas and vendors as needed
- Process provider requests as needed
- Act as member s first trusted source for WCM programs
- Schedule appointments between the member and coach in appropriate systems
- Assign referrals to designated staff
- Process requests for compliance inquiries
- Access various WCM department mailboxes and voicemail as neede
- Ability to function independently
- Critical Thinking
- Quick learner
- Bi-Lingual/Spanish
TekWissen Group is an equal opportunity employer supporting workforce diversity.
