Healthcare Support Specialist

3 weeks ago

Nashville, Tennessee, United States Lucent Health Solutions, Inc. Full time

About Lucent Health Solutions, Inc.

Luent Health Solutions, Inc. combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions.

Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time.

Our Company Culture

We believe that the success of Lucent Health Solutions, Inc. relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health Solutions, Inc.

Honest

Transparent Communication:

be open and clear in all interactions without withholding crucial information

Integrity:

ensure accuracy in reporting, work outputs and any tasks assigned

Truthfulness:

provide honest feedback and report any issues or challenges as they arise

Trustworthiness:

build and maintain trust by consistently demonstrating reliable behavior

Ethical

Fair Decision Making:

ensure all actions and decisions respect company policies and values

Accountability:

own up to mistakes and take responsibility for rectifying them

Respect:

treat colleagues, clients and partners with fairness and dignity

Confidentiality:

safeguard sensitive information and avoid conflicts of interest

Hardworking

Consistency:

meet or exceed deadlines, maintaining high productivity levels

Proactiveness:

take initiative to tackle challenges without waiting to be asked

Willingness:

voluntarily offer to assist in additional projects or tasks when needed

Adaptability:

work efficiently under pressure or in changing environments

About the Role

The Support Specialist is a key part of the Concierge Team based in the Narus Member Support Center in Nashville, Tennessee.

The Support Specialist, as a part of the multidisciplinary care team, is responsible for compassionately helping patients with the insurance complexities that arise when diagnosed with complex illnesses, recovering from a traumatic clinical event, and/or providing general member support.

This role administratively supports the multidisciplinary team by assisting members with navigating the complexities of self-funded insurance, benefits, eligibility inquiries, locating providers and facilities, general customer service assistance, and address non-clinical issues that impact quality of life and outcomes.

Responsibilities:

The Support Specialist supports the multidisciplinary care team by ensuring seamless delivery of the Narus program for individuals and their families by providing the following services:

Key Responsibilities:

Providing an excellent member experience through direct communication through high volume inbound and outbound calls and secure messages.

General Support Specialist duties including:

Educate members on benefits plans including items such as: deductibles, in/out of network inquiries and other benefit questions.

Assist in preventing and/or resolving delay in care by educating providers/facilities on RBP insurance.

Confirm the deployment and receipt of ancillary services such as home health, DME, radiology, and community based social services.

Aid and resolve patient issues regarding locating accepting providers.

Maintain case load in a timely manner.

Additional Responsibilities:

Perform appropriate triage and escalation of routine and urgent patient calls to the clinical team when appropriate.

Calls external facilities and providers to execute on care plan issues for patients.

Make outbound patient calls to coordinate non-clinical patient needs.

Assist care team with locating community resources for our patients.

Assist office-based team with faxing, documentation, and telephonic/virtual support of care management priorities.

Participate in weekly team meetings and bi-weekly one on ones.

Qualifications

A minimum of two (2) years of related experience or equivalent, preferably in a physician office or clinical call center.

High school diploma required.

1 week in-office training required in Nashville, TN.

Highly Desirable:

Knowledge of Reference-based pricing (RBP) and understanding the relationship between self-funded insurances and third-party administrators preferred.

Patient, compassionate, and professional personality with a strong service orientation.

Demonstrated problem solving skills.

Proficient on Microsoft Office programs, EMR/Care Management platforms, and keyboarding.

Demonstrated knowledge of legal and ethical issues related to confidentiality, including HIPAA and state specific privacy laws.

Commitment to excellence and high standards.

Ability to analyze complex data, draw conclusions, and act on that information in a timely manner.

Ability to apply problem-solving techniques to the case management process.

Excellent time management, flexibility, and organizational skills with the ability to work independently.

Critical thinking and good judgement to quickly determine and prioritize issues

Good communication, teamwork, and interpersonal skills with the ability to work with all levels of management.

Prior telephonic patient engagement or care coordination experience required.

Previous experience in medical claims and billing preferred.

Benefits

We offer a competitive, comprehensive benefits package that includes Health, Dental and Vision Insurance, Employer-paid Life, Supplemental Life and AD&D, Voluntary STD, Accident, and Critical Care Insurance, discounted Auto, Home, Renter, and Condo Insurance, Wellness, EAP Services, Paid Training, and Paid Vacation and Holidays.

AN EQUAL OPPORTUNITY EMPLOYER

Luent Health Solutions, Inc. is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

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