Job Description
The Resolution Specialist is responsible for providing high quality client focused service by using knowledge of local, state, and federal program requirements to efficiently maintain and update general applicant information, financial, medical and personal information to support client applications. WHAT WILL MY DUTIES AND RESPONSIBILITIES BE IN THIS JOB?
Monitors and fosters ongoing communications with government agencies regarding the status of claims.
Documents and updates internal database based on daily contact of select members of assigned applicant group and application evidence requirements, i.e., work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.
Reviews inbox for daily work queues, identifies missing evidence and follows through to completion.
Answers incoming calls from internal and external Customers.
Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process.
Effectively educates and answers inquiries from patients and family representatives regarding application process.
Assists clients with scheduling appointments and reminding of appointments, as needed.
Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process.
Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval.
Identifies appropriate escalation points and works with direct manager to resolve issues.
Reviews outgoing client material for accuracy prior to submittal.
Complies with ethics, privacy and compliance policies and procedures.
WHAT ARE THE REQUIREMENTS NEEDED FOR THIS POSITION?
High School diploma or equivalent; Associates degree preferred.
Computer skills, including MS Excel and basic keyboard skills required.
1+ yrs. experience in call center, claims or customer service.
WHAT OTHER SKILLS/EXPERIENCE WOULD BE HELPFUL TO HAVE?
Fluency in both English and Spanish languages helpful
Ability to apply knowledge of federal and state programs to benefit coverage for the client
Strong communication skills (verbal & written); demonstrated experience working with people of various educational, experience communicating government caseworkers and hospital personnel
Strong organization skills – ability to prioritize, plan
Ability to work independently and follow tasks through to completion without direct supervision
Understanding of state and federal benefits
STRONG CRITICAL THINKING SKILLS
WORK ENVIRONMENT AND SCHEDULE:
Work-from-home, quiet workspace needed, high speed internet required (no satellite internet).
Fulltime, 40 hours weekly. Monday through Friday, an 8 am - 5 pm EST.
Company Description
As of April 2017, Change Healthcare is one of the largest, independent healthcare technology companies in the United States. Working alongside our customers and partners, we enable better patient care, choice, and outcomes at scale. As a new company, Change Healthcare has increased capabilities for innovation, investment, and customer service. What we do and who we are: Supports over 300 practices/ 4000 Physicians. Our division is Patient Access- what does that means: o We view Patient Access as a concierge service for patients o We work with large academic hospitals and private health systems (ranked high in US). We offer the following: o Scheduling of both new and existing patients o RX refills o Physician referral (Patients looking for a new doctor) o Radiology – Diagnostic out-patient scheduling o Help Desk Support of online patient portal o RNs that work with Patients that have recently being discharged from the hospitals. Who are our customers/clients? o Large, nationally recognized academic hospitals o Private Health Systems.