Behavioral Health Care ServiceTechnician I - M-F 11:30 AM to 8 PM
Job ID 2013-22096 # Positions 1
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 2/26/2013
Additional Locations ..
More information about this job:Summary:
Member of a team dedicated to supporting the Behavioral Health (BH) Call Center and administering the Amerigroup Behavioral Health programs. Interacts internally and externally with providers and members to process prior authorizations using clinical protocols. Also interacts with the National Call Center in resolving specific member issues related to Behavioral Health programs.
1. Responsible for telephonic member and provider calls related to Amerigroup Medicaid/Medicare population., to include member calls seeking BH benefits information or locating a Provider offering BH services and calls from Providers or Facilities related to Amerigroup Behavioral Health program.
2. Initiates/completes prior authorization requests via phone and fax; obtains additional information via fax from requesting provider and documents all pre-certification/authorization requests, as well as member encounters, utilizing the appropriate systems or resources and in accordance with documentation standards.
3. Function as a referral source for Members or Providers. Have the ability to access system provider lists and give appropriate network referrals.
4. Work closely with members, providers or community agencies to proactively coordinate access to services utilizing their knowledge of community resources.
5. Coordination, authorization, fulfillment, monitoring or tracking of health care services.
6. Adhere to all state accreditation standards or regulatory guidelines, which include HIPAA guidelines, while maintaining member confidentiality.
7. Adhere to key performance measures including average speed of answer, abandon rate and average talk time as well as productivity and quality measures.
8. Perform other duties as assigned.
EDUCATION AND EXPERIENCE
Years and Type of Experience Required:
- Associate or Bachelor Degree, or Equivalent Experience.
- Minimum of three (3) years customer service experience, with one (1) year experience in a health care operations environment, or
- Minimum of (3) years customer service experience, with one (1) year experience in a call center environment.
- Basic knowledge of MS Office Suite applications, such as Word and Outlook.
- Computer keyboarding skills.
- Excellent Communication skills, both written and verbal.
- Well organized and customer focus.
- Strong analytical skills.
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.
AMERIGROUP Corporation - 18 months ago
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AMERIGROUP looks after the health of America's needy. The managed health care provider targets people eligible for Medicaid, the State...