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Job Information
G-TECH Services, Inc. Precertification Specialist in Detroit, Michigan
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 areas
and vendors as needed
- Process
provider requests as needed
- Act as
member 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
Bi-Lingual/Spanish
Category Clerical
Function Clerical / Administrative
Req ID JN -062024-121308