Research, verify and resolve inquiries related to Oregon Health Plan (OHP) or Medicare eligibility.
Respond and assist members with Primary Care Provider (PCP) assignments and explain OHP or Medicare benefit coverage.
Collaborate with providers, Division of Medical Assistance Programs (DMAP), and members to ensure effective customer service and the resolution of any health plan issues that arise.
Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals
Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members
Assist individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups
Pair Team is an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, they deliver whole-person care, and leverage AI and automation to reduce administrative burden. They are deeply collaborative with nurses, social workers, community health workers, and medical professionals.
Manage multiple channel interactions professionally and efficiently.
Effectively present products/services to providers with integrity, understanding, and accuracy.
Focus on provider retention through first call resolution and maintain positive relationships.
Capital Blue Cross promises to go the extra mile for its team and community. Employees consistently vote it one of the “Best Places to Work in PA”, valuing professional/personal growth by investing heavily in training and continuing education.
Team members will perform outbound calls to enroll the person into their food box program or to reauthorize the person into the program.
Have a passion for helping members make decisions that will enhance their healthcare experience
You will be making a difference in someone’s life!
Carenet Health has pioneered advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Enjoy making outbound calls and reaching out to patients, members, and customers
Outreach to patients to schedule appointments for preventative health screenings
Assist members and patients with benefits and insurance information
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. Interacting with 1 in 3 Americans every day, they deliver positive healthcare experiences and improving outcomes.
Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.
Creates cases, tasks, and completes assessments in Case Management module for all Hospital and SNF discharges
Works as a team with the Case Manager to engage and manage a panel of SNP members
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.
Engaging patients over the phone to deliver services, explaining clinical programs and benefits.
Identifying potential medication and health-related issues and escalating them to the pharmacist.
Answering phone calls from patients, providers, and pharmacies and responding to inquiries professionally.
Arine is a healthcare technology and clinical services company focused on ensuring individuals receive the safest and most effective treatments. They are backed by leading healthcare investors and collaborate with top healthcare organizations, managing more than 18 million lives across health plans.
Collaborate with core team members and department heads to navigate customers' needs and deliver optimal results.
Interact with customers, building strong relationships, and practicing customer advocacy.
Eager to learn, strives for excellence, and is committed to building a long-term career.
Helpware is a technology-driven company that provides Customer Experience & Operational Support for modern companies. Our team is driven by the purpose of providing best in class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.
Guiding them toward scheduling their care assessments.
Giving them the encouragement they need to take that next step.
Carenet Health turns everyday conversations into meaningful connections that help people take charge of their health. They value their team members and show it through a competitive and supportive package.
Answer a high volume of inbound calls; transfer and directs calls; provide exceptional customer service via telephone
You’ll be responsible for all front office patient coordination; to be completed in a timely manner (e.g. appointment scheduling, transport coordination)
Communicate clearly and effectively (both oral and written) with patients, clients, Team Members, peers and Leadership.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Possess strong oral and written communications skills.
Exhibit excellent interpersonal skills using tact, patience, and courtesy.
Thoroughly and efficiently gather customer information, assess, and fulfill customer needs and educate customers where applicable.
SMI is a leading provider in government payment solutions, developing state-of-the-art solutions and running complex human services operations. With over 53 years in operation as a family-owned business, SMI has grown to over 600 employees across the country, and considers its employees and customers as part of their extended family.
Communicate with our members via phone and email. exhibiting care in every interaction
Listen to our members, providing empathy and solutions to their unique needs
Accurately document Member interactions and activity
Achieve is a leading digital personal finance company that provides innovative, personalized financial solutions. They have over 3,000 employees in hybrid and work-from-home roles across the United States with hubs in Arizona, California, and Texas and put people first.
As the first point of contact, you'll assist patients and providers.
Interwell Health is a kidney care management company that partners with physicians to reimagine healthcare. They aim to set the standard for the industry and help patients live their best lives and is committed to diversity, equity, and inclusion.
Serve as the first point of contact for incoming calls from patients and internal teams.
Deliver clear explanations of insurance benefits, out-of-pocket costs, and payment options.
Review patient accounts and resolve billing-related concerns with professionalism and urgency.
Metro Vein Centers specializes in state-of-the-art vein treatments, with a mission to improve patients' quality of life. With over 60 clinics across 7 states, they deliver compassionate, results-driven care in a modern, patient-first environment and maintain a high patient satisfaction score.
Build rapport with families, healthcare providers, and insurance companies in a compassionate manner.
Educate potential families about evaluation, treatment, and insurance processes.
Provide excellent customer service and expedite the process for families.
Cranial Technologies researches and treats plagiocephaly (commonly called flat head syndrome). They have treated over 300,000 babies with the DOC Band® and are the leader in pediatric cranial shaping orthoses. They also provide treatment with EarWell® to correct infant ear shapes without surgery, with 600,000+ successful outcomes.
Outbound calls, calling members to inform them of their Specialist Management Solutions benefits and act as a care guide on behalf of the customer helping them receive treatment from a network of high-quality surgeons
Receive inbound calls from members to educate them on their Specialist Management Solutions benefits and provide guidance with appointment scheduling
Assist in the coordination of care across a variety of settings, while maintaining strict confidentiality and the highest level of professionalism
Lantern is a specialty care platform connecting people with the best care when they need it most. They curate a Network of Excellence comprised of the nation’s top specialists for surgery, cancer care, infusions and more, delivering excellent care with significant cost savings to employers and their workforces.
Provides exceptional customer service and engagement via telephone.
Ensures customer satisfaction by providing quality service, identifying customer needs and assisting them with healthcare related issues/concerns.
Researches, identifies and solves problems; verify eligibility of services and places call backs as required.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Answer calls, emails, and contacts, screening, transferring, resolving and disposing of calls while following process/documentation standards.
Review, process, schedule, and authorize orders according to department protocols; ensure updates and communication are documented in source systems.
Coordinate participants’ appointments, troubleshoot conflicts, communicate with stakeholders, and meet appointment turn-around times as outlined in WelbeHealth's protocol.
WelbeHealth's PACE program helps seniors remain in their homes and communities through medical care and community-based services, providing all-inclusive care. They are driven by core values and a participant-focused approach, fostering an encouraging and loving environment for employees.
Provide prompt and courteous assistance to customers via various channels.
Sell and quote new business to both personal and commercial lines clients.
Assist in preparing and processing commercial insurance policies.
Trucordia is an insurance brokerage that brings together people, tools, and solutions. They have over 5,000 team members across 200 offices and are ranked as one of the fastest-growing companies in the U.S. for three consecutive years.
Handle inbound and outbound calls to prospective clients, creating a friendly and inviting atmosphere to discuss Aetna’s Medicare plans.
Clearly explain Medicare options, benefits, and enrollment processes, ensuring clients feel informed and confident in their choices.
Take the time to understand each client’s unique needs and adapt your approach to provide tailored solutions.
Ignitist Inc, which is part of the Trucordia Insurance Services Network, provides insurance solutions to help veterans, disabled Americans, and underserved populations get access to the healthcare they need. Ignitist Inc is building a virtuous network with non-profit groups, insurance carriers and providers who share our passion for improving the quality of life for those who need it most.
Receive and respond to prescription refill requests through various communication channels.
Verify the validity and accuracy of prescription refill requests, ensuring compliance with regulatory guidelines.
Prepare and dispense prescription refills accurately and efficiently, following established organizational protocols and procedures.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.