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Medicare Advantage Support Specialist

2 months ago

Lisle, United States Duly Health and Care Full time
Overview

The Medicare Advantage Patient Care Coordinator will serve as the subject matter expert, and personal resource, for our Medicare Advantage patients. This role will provide specialized care to our Medicare Advantage patient population in a call center environment. This care may include answering and directing patient calls, collaborating with nurses, contacting providers, coordinating care, as well as the accurate and timely scheduling of appointments across all primary, specialty and behavioral health providers. The Medicare Advantage Patient Care Coordinator will be committed to removing barriers to care services and promoting positive patient health outcomes.

Responsibilities

• Medicare Advantage Specialized scheduling (50%)
a. Processing of inbound contact center interactions via multiple modes of communication ranging from phone calls to electronic written responses via My Chart
b. Cross functional scheduling across all areas of Duly health and Care (Primary Care Physicians, Specialty Physicians and Behavioral Health)
c. Coordination with site clinical and managerial staff to provide prioritized scheduling for our Medicare Advantage patients
d. Identifying clinical patient concerns and escalating to Central Nurse Triage or the appropriate physician site/department as needed
e. Verifying, cancelling, scheduling, and rescheduling appointments across all Duly service lines.
f. Answer general scheduling related questions
g. Registration/Patient Account Support
h. Participate in mentoring and training initiatives to improve patient care
i. Collect patient payments and outstanding balances

• Medicare Advantage Guidance and Coordination (30%)
a. Performs and delegates tasks to facilitate patient care as appropriate based on patient need and Medicare Advantage guidelines
b. Serves as a peer resource to new and existing team members to improve Medicare Advantage knowledge
c. Educates office staff on Medicare Advantage Regulations to enhance patient care and improve the patient experience

• Update patient information in Electronic Medical Record (20%)
a. Update patient information and demographic changes upon request
b. Update Insurance information upon request

Qualifications
• Highschool Diploma or GED (required)
• Excellent verbal and written communication
• Active listener who can analyze patient needs and prioritize patient satisfaction
• Able to identify, analyze, and solve problems
• Proven ability to multitask and prioritize daily work in a fast-paced contact center environment
• Proficient with using multiple computer programs and applications simultaneously
• Able to work independently and as a member of a team
• Able to diffuse tense situations
• Knowledge of HIPAA and all areas of scheduling, including medical terminologies, provider templating, and accepted insurance coverage (preferred)
• Knowledge of Medicare Advantage Plans (preferred)
• Bilingual (Spanish) (preferred)
• 1 - 2 years Call Center and/or Customer Service environment (required)
• 2 years' experience in Medical Office Setting (required)
• 1 - 2 years' experience with Epic or EMR (preferred)