Care Specialist-Clinical Operations
RemoteUnited States
Job Summary
Receive inbound calls from members, physicians, and clients to process requests per Sagility policies, and execute outbound projects for enrollment and satisfaction surveys. Route messages to appropriate nurses, document pertinent notes in patient charts, and validate demographic information including insurance types. Obtain pre-certification or authorization numbers for referrals, maintain HIPAA confidentiality, and use applications to ensure quality service delivery. Demonstrate strong communication skills while navigating the healthcare system and escalating issues appropriately. Work remotely with regular attendance and timeliness, performing other duties as assigned.
Required Qualifications
- High School Diploma or equivalent
- A minimum 1-year experience working in an office setting as a receptionist, telephone customer service representative, or telemarketing representative
- Good communication skills via telephone with members, customers, peers and superiors
- Excellent interpersonal skills
- Ability to understand and interpret policy provisions
- Product knowledge
- Typing Skills
- Problem Solving Skills
- Proficient computer skills
- Demonstrates empathy
- Ability to work remotely
- Ability to determine when to escalate issues appropriately and in a timely manner
- Regular, reliable attendance and timeliness
Desired Qualifications
- Direct experience in a telehealth support function
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