Perform prospective, concurrent, and retrospective utilization review to ensure medical necessity and appropriate level of care.
Research and respond to appeals, coordinate discharge planning, and analyze care patterns.
Collaborate with providers and internal teams to resolve benefit and eligibility issues.
HealthEdge provides AI-powered operational infrastructure for health insurance companies, helping them modernize operations and compete effectively. The company is expanding and investing in its people, offering opportunities to shape the future of healthcare technology.
Conduct Medicare Annual Wellness Visit screening questionnaires with patients by phone.
Document patient responses accurately in the EMR during the call.
Support eligible patients with scheduling their wellness screenings.
Welltality is a healthcare company that conducts Medicare Annual Wellness Visit screenings by phone, offering a remote alternative to traditional clinic environments. The company emphasizes flexibility, supportive management, and a collaborative team culture, with team members often staying long-term.
Conduct outbound calls to members to schedule Annual Wellness Visits, preventive screenings, and primary care consultations.
Educate members about available healthcare benefits and the importance of completing recommended visits.
Coordinate with provider offices and internal teams to secure appointment availability and maintain accurate documentation.
This company provides population health and care coordination programs, helping members access preventive and primary care services. The team operates as a remote, performance-driven call-center environment focused on member outreach and appointment scheduling.