Bilingual Spanish Support Specialist

This is a fully remote position, open to applicants in Connecticut, +2 more states.

📋 Description

• Support care/case managers with non-clinical tasks such as case and event creation.

• Conduct telephonic outreach to members, providers, and community organizations.

• Manage member mailings.

• Fax clinical requests and Individual Health Care Plans on behalf of care/case managers.

• Reach out to newly enrolled members to discuss current and approved services, DME, and additional requests.

• Review intake documents for pre-approved services and escalate any discrepancies.

• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments, identifying issues or risk factors that may require clinical escalation.

• Initiate, finalize, update, and discontinue authorizations in Trucare for pre-approved services and DMEs.

• Document calls related to benefit inquiries, appointments, assessments, service issues, grievances, authorizations, referrals, visits, tests, and care plans.

• Educate members and providers about the requirements for service-request approvals.

• Oversee a large caseload and monitor member screening to enhance quality and cost outcomes.

• Communicate with inter/intra-departmental teams regarding onboarding concerns.

• Perform additional duties as assigned.

⛳️ Requirements

• High School diploma or GED equivalent.

• Background in a customer service setting.

• Experience in a fast-paced environment that necessitates handling multiple priorities at once.

• Work experience that requires effective verbal and written communication, demonstrating strong grammar, spelling, and punctuation skills.

• Bilingual in English and Spanish.

• Familiarity with medical terminology.

• Proficiency in Trucare, Salesforce, HHAXchange, DocuSign Epaces, and Sharepoint.

• Experience in managed care or other healthcare sectors, particularly in a Call Center or Care/Case Management Department.

• Proficient in Microsoft Office Suite applications, including Excel, Word, Outlook, and MS Teams.

• Proven ability to document calls in a computerized system.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Incentive and recognition programs.

• Life insurance.

• 401k contributions.

• Competitive compensation and benefits package.