Health Navigator (Telephonic) - Evening Shift - REMOTE (R) (Remote)

Required skills & experience:

  • MUST have experience in customer support and call center environments

  • MUST have some experience at a health plan. Prefer candidates that have worked with a major insurance company (BCBS, UHC, etc)

  • Will need to be on the phone or answering emails during the entire shift

  • Bi-lingual in English/Spanish a plus

  • Excellent telephone manner and skills

  • Must have at least three (3) years of customer service experience

  • Must have at least one (1) year of telephonic experience discussing confidential medical information to consumers

What you need to know:

  • Great opportunity to join a healthcare company

  • Shift from 10:30 AM – 7:00 PM EST

  • Local to Pembroke or Remote in the US

  • Will need to travel to Pembroke, MA for training. Training lasts 4-6 weeks and is a combination of remote and onsite training

We are currently hiring a Health Navigator (Telephonic) who will be the first point of contact for our participants. We are looking for someone who understands basic clinical terminology, has worked in a customer service environment, enjoys speaking on the phone and has at least one year of experience working with consumers in a health-related environment.

 Job Responsibilities

  • Handle incoming, outgoing, email and chat communication within a call center environment;

  • Assist participants in navigating their employer benefit suite, including their health plan, pharmacy resource, general benefits administration and the like, with the goal of driving resolution on behalf of the participant by connecting them to the appropriate resource and assisting in resolution;

  • Recognizing/acknowledging the need for additional research in order to resolve any unresolved issues, and handle associated casework;

  • Build effective rapport with customer-vendor partners and use expertise to ensure that all the needs of the participant(s) are identified and addressed;

  • Prioritize the most important service needed on behalf of the participant (coaching, information, emotional support, web navigation, health benefits navigation);

  • Responsible for educating and promoting CM services that are available with a goal of increasing engagement;

  • Utilizing interpersonal skills and training to provide professional, knowledgeable, helpful, courteous, and responsive customer service;

  • Work closely with the nurse team and/or other teams to determine the best method to satisfy participants need(s);

  • Comfortable communicating medical information to a non-medical audience;

  • Access customer accounts and product information, by toggling between multiple screens and systems, to provide accurate answers and support within the parameters of policies and procedures;

  • Conduct feedback surveys with participants to evaluate satisfaction, utilization of services provided and impact of CM services;

  • Staying current on customer programs and workflows through on-going communications.

Experience with the following:

  • Navigating employer health benefits including health care coverage, pharmacy benefits, general benefits administration, etc.

  • Patient advocacy

  • Dedicated to providing high quality, professional, customer service

  • Enthusiastic, must enjoy working independently and in a team environment

  • Bi-lingual in English/Spanish a plus

  • Proficient with Microsoft Office Suite (Excel, Word, Outlook, Powerpoint)

  • Flexible and willing to perform other tasks as assigned

  • Excellent written and verbal communication skills

  • Must be comfortable with a fast-paced, evolving operation

  • Experience with resolving complex participant issues regarding billing, claims, benefits and general inquires

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