WCMCCM ECPrecert Specialist
Posted on :
28-06-2024
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Job Description
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
Note: Anticipated work hours are between 8:00a.m. 5:00p.m
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
Education/Certifications Include:
- Associate degree level preferred
- 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 members 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 needed
- Ability to function independently
- Critical Thinking
- Quick learner
- BiLingual/Spanish
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full Time
Key Skills
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