Inbound/Outbound Queue Associate

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary - Supports comprehensive coordination of medical services including intake, screening, and referrals to reputed company reputed company. - Promotes/supports quality effectiveness of Healthcare Services. - Performs intake of calls from members or providers regarding services reputed company telephone, fax, EDI. - Utilizes reputed company system to build, research and enter member information. - Screens requests for appropriate referral to medical services staff. - Approve services that do not require a medical review in accordance with the benefit plan. - Performs non-medical research including eligibility verification, COB, and benefits verification. - Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. - Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively) - Protects the confidentiality of member information and adheres to company policies regarding confidentiality. - Communicate with reputed company Case Managers, reputed company processing transactions for members active in this Program. - Supports the administration of the precertification process in compliance with various laws and regulations and/or NCQA standards, where applicable, while adhering to company policy and procedures. - Places outbound calls to providers to provide information or obtain clinical information for approval of medical authorizations. - Uses reputed company Systems such as MedCompass, QNXT, SSA, ProFAX and ProPAT. - Communicates with reputed company Nurses and Medical Directors reputed company processing transactions for members active in this Program. - Sedentary work involving significant periods of sitting, talking, hearing, and keying. - Work requires visual acuity to reputed company reputed company inspection of written and computer-generated documents as well as a PC monitor. Required Qualifications 1-2 years’ experience working as a medical assistant, office assistant or other clinical/equivalent experience. -Must reside in Florida Preferred Qualifications - Call center experience is preferred, 1-2 years - Prior authorization experience, 1-2 years Education High School diploma or equivalent GED. Pay Range The typical pay range for this role is: $17.00 - $25.65 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 10/29/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area Apply Job!