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Medical Scheduler (Remote)

  • 0 yrs
  • $ Not Disclosed / YEAR

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Job Description

The Welbe Advocate I is responsible for two primary functions within the Welbe Advocate Hub, based on assignment. A Welbe Advocate I may be assigned to either inbound and/or
outbound assignments within the Hub which could include but not be limited to call management (answering inbound calls), outbound scheduling, authorization processing,
inquiry response, clinic-based scheduling and/or other administrative tasks. The Welbe Advocate I will provide outstanding customer service to all stakeholders (participants, families, partners, and team members) and will be responsible for proper documentation and maintaining current and accurate records of all the scheduled appointments. The Welbe
Advocate I role requires ability to work in a fast paced, participant centric environment. The Welbe Advocate I must be comfortable with multitask work dynamics while still able to
collaborative effectively with colleagues and stakeholders to promote the WelbeHealth values, team culture and mission.


 


Duties and Responsibilities: 



  • Answer incoming phone calls, emails, contacts as requests coming into the Hub.  Appropriately screen, transfer, resolve and dispose of calls expeditiously which adhering
    to all process and documentation standards.

  • Review, process, schedule and authorize orders according to department protocols.

  • Ensure that appropriate and timely documentation of all updates, encounters and communication is documented in source systems as outlined by department protocols.

  • Effectively coordinate the scheduling of participants appointments, including troubleshooting conflicts or urgent needs, communicating with all stakeholders (staff, family,
    providers etc.) and meeting appointment turn-around times as outlined in WelbeHealth Appointment Scheduling Protocol.

  • Respond to questions and inquiries regarding authorization status and requirements.

  • Provide eligibility status and benefit information for participants.

  • Collect/Update and Verify Participant and Provider information as required.

  • Address both participant and provider inquiries and if unable to resolve, escalate as appropriate.

  • Conduct appointment confirmations and appointment reminders as outlined by department protocols, updating appointments as appropriate.

  • Maintain current and accurate records of all scheduled appointments – scheduled times, outcomes (e.g., appointment occurred or not, reasons for rescheduling).

  • Trouble-shoot and resolve basic issues; escalate to manager when appropriate.

  • Complete all required documentation in a timely and accurate manner.

  • Protect privacy and maintain confidentiality of all company procedures and information about team members, participants, and families.

  • Follow WelbeHealth policies and procedures and participate in any required Quality Improvement activities, staff training and meetings.

  • Communicate regularly with Supervisor and team regarding workload and priorities.

  • Timely completion of all mandated trainings and education.

  • Timely completion of all mandated occupational health screenings as needed.

  • Exercises flexibility in performing assignments as business needs evolve.

  • Other duties as assigned.


 


Qualifications and Requirements:



  • High School Diploma or Equivalency required.

  • Minimum of one year experience working in a call center environment where a service/support role was primarily performed.

  • Minimum of (1) year experience working in health care or PACE setting a plus.

  • Outstanding customer service orientation, especially in telephone and written communications.

  • Excellent and accurate data entry skills and experience in multiple software platforms.

  • Must be flexible with work hours.

  • Problem solving and persistence in the face of challenges.

  • Excellent organizational and communication skills.

  • Ability to work independently with minimal supervision.

  • Demonstrated ability to prioritize in a fast-paced environment.

  • Experience and competency working with people from diverse backgrounds and cultures.

  • Commitment to unlocking the full potential of our most vulnerable seniors.

  • Bilingual English/Spanish preferred. 


 


Medical Clearance:


Required that Team Members must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact. Additional screening may
be required as determined by the Medical Director and Human Resources Director in order to protect participants and the community from communicable disease outbreaks (e.g.,
COVID-19).


Regulatory Requirement ongoing:


Must not be on any exclusion or debarment from participation in Federal Health Care Programs at any time and must remain in good standing with government regulators such
as the OIG, (Office of the Inspector General), SAM, (System for Award Management), CMS (Centers for Medicare and Medicaid Services), etc. 


Physical Demands and Working Conditions:
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the
essential functions of this job. In compliance with ADA requirements, reasonable accommodations may be made to enable individuals with disabilities to perform essential
functions.


• Work Environment: Team Member must be able to work effectively within an interdisciplinary team model, interfacing and collaborating with a wide range of
clinical and social services disciplines who work together to manage the PACE participants' care. The work setting is in an Adult Day Health Center, primary care
clinic, other healthcare settings like hospitals, emergency departments and participant home environment with moderate noise levels and controlled
temperatures. 


• Physical Requirements - Requires corrected vision and hearing to normal range.  Must be able to communicate with all staff, vendors, and clients. Requires manual and finger dexterity and eye-hand coordination; the ability to use department equipment. Requires lifting/carrying up to 65 lbs. and pushing or pulling 150 lbs.
using appropriate body mechanics and equipment, with reasonable accommodation if needed.


Visual, Hearing and Communication Requirements - Requires corrected vision and hearing to normal range, with or without reasonable accommodation. Ability to
communicate by way of the telephone with participants, customers, vendors, and staff.


Pressure Factor - Requires working under stressful conditions. Working conditions may be noisy and crowded and fluctuating indoor temperatures. Moderate pressure
to meet scheduled deadlines. Potential for exposure to verbal aggression by Participants and/or their family members who may suffer from comorbidities such as
dementia or mental health challenges.


Environmental Conditions - May be exposed to a risk of bodily injury through contact with moving instrumentation, toxic substances, medicinal preparations, bodily
fluids, communicable diseases and any other conditions common in a healthcare environment. May be subjected to unpleasant odors.



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