Support Specialist, Bilingual Mandarin, Cantonese

This is a fully remote position, open to applicants in Connecticut, +3 more states.

📋 Description

• Support care and case managers with non-clinical tasks, including case and event creation.

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

• Manage member mailings efficiently.

• Send clinical requests and Individual Health Care Plans via fax on behalf of care and case managers.

• Perform outreach for newly enrolled members to discuss current and approved services, durable medical equipment (DME), and other requests.

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

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

• Initiate and finalize authorization in Trucare for preapproved services and DMEs; update or discontinue authorizations as needed.

• Accurately log communications with members regarding benefit inquiries, appointments, assessments, service concerns, and grievances.

• Accurately record interactions with providers regarding authorizations, referrals, visits, tests, and faxed care plans.

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

• Manage a substantial caseload, effectively communicating member issues and monitoring screenings to enhance quality and cost outcomes.

• Collaborate with inter- and intra-departmental teams regarding onboarding challenges.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• High School diploma or GED equivalent.

• Experience in a customer service setting.

• Proven ability to thrive in a fast-paced environment requiring the management of multiple priorities simultaneously.

• Work experience demonstrating effective verbal and written communication skills, including good grammar, spelling, and punctuation.

• Proficient in English and bilingual in Mandarin/Cantonese.

• Familiarity with medical terminology is essential.

• Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, and Sharepoint.

• Experience in managed care or a related area of the healthcare industry, particularly in a Call Center environment or Care/Case Management Department.

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

• Demonstrated capability 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.