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.
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