The Intake Specialist Outbound (Bilingual/Spanish) - Remote talks directly with patients and their families, determining their needs, their medical history, physical and mental state and special requirements. The role provides excellent customer service and appropriately documents requested appointment.

The Appeals Specialist II position plays a critical role ensuring that PEHP member and provider appeals are researched according to Master and Corporate Policy. This role performs reviews for medical, dental, FSAs, and enrollment appeals disputed by members or providers, requiring knowledge of PEHP policies and strong communication skills.

Coordinates, monitors, and manages the follow-up on unpaid claims, ensuring follow-up and reimbursement appeals of unpaid and inappropriately paid claims. Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims. Review and work all daily correspondence and appeal denied claims.

The Care Coordinator Level 1 role ensures seamless, high-quality support and service delivery across the care continuum. As a first point of contact, Care Coordinators provide empathetic, efficient, and solution-oriented assistance, contributing to reinventing women’s healthcare. This role works collaboratively to coordinate care, resolve member concerns, and deliver an exceptional experience.

Provide top-tier service by delivering fast, accurate, and effective solutions to Billing customers, resolving technical issues regarding billing and claims processing, guiding customers on best practices for revenue cycle management, and ensuring compliance with HIPAA regulations.

Ensure that patients are treated with the highest level of confidentiality and professionalism, maintain incoming patient calls and responding to voicemails promptly and courteously. Manage patient billing emails and portal messages, support as Liaison between billing and operations, and handle mailing secondary claims to insurance companies.

As a Customer Service Agent, you will be the face of the company, handling inbound inquiries and resolving issues efficiently. You are responsible for providing accurate information, empathizing with customers, and managing support tickets. Maintaining high customer service standards will be crucial, and ensuring a positive member experience by addressing and resolving member issues efficiently.