Support Specialist
Healthfirst · US
The Support Specialist is responsible for assisting the primary care/case managers (PCM/CM) with non-clinical activities such as providing telephonic outreac...
Job description
The Support Specialist is responsible for assisting the primary care/case managers (PCM/CM) with non-clinical activities such as providing telephonic outreaches to members for completion of service assessments, outreaches to providers and community-based organizations regarding service initiation and/or continuation, handling member mailings; faxing clinical requests and approved authorized service plans. Duties and Responsibilities: - Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests - Review intake documents for pre-approved services and escalate discrepancies as needed - Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM. - Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable - Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances - Handle and accurately document calls to...