Care Guide (non-RN) - Apree Health

Description

• Represent apree health to external and internal customers with empathy, compassion and ownership of best resolutions
• Provide a multi-channel approach to world class service, ensuring the individual needs of each person are anticipated and met to the best of your ability
• Exhibit developed expertise of our digital product and provide assistance that exceeds expectations and engages the customer in the process
• Work on behalf of the individual to resolve potential billing and coding discrepancies when applicable
• Partner with providers and payers to resolve questions and barriers to care
• Provide navigation, interpretation and assistance with insurance details, processes and cost transparency
• Open enrollment support when needed
• Explore and connect to the appropriate health plan benefits, employee offerings and supportive programs to improve healthcare outcomes
• Explore and connect to the appropriate in-network, high quality, primary/preventive care recommendations
• Schedule/coordinate appointments and follow up as appointed
• Work with external care teams and 3rd party sources to coordinate the best outcome for the individual
• Explore and locate resources for the removal of barriers to care whenever possible
• Participate in wellness and incentive campaigns to boost engagement and improve outcomes
• Adhere to all company policies, PHI and PI guidelines and applicable laws
• Escalate when appropriate to designated clinical or technical teams per process guidelines
• Utilize good documentation practices and follow outlined documentation and system requirements
• Must be eager to receive and apply routine feedback for continuous improvement as a result of call and case reviews
• Other duties as assigned

• High School diploma preferred
• Proven customer service skills in healthcare setting
• Telehealth and contact center experience preferred
• Previous medical office experience preferred including (but not limited to), Medical Assistants, Billing and Coding Specialists and medical admins, patient advocacy
• Experience with preferred technologies a plus (EMR, Salesforce, Google)
• Focused attention and dedication to critical thinking, problem solving, empathetic listening and thoughtful responses
• Strong, professional verbal and written communication skills
• Attention to detail ability to multitask with exceptional organizational skills
• Previous case management experience is a plus
• High tolerance for a fast-paced environment with change management skills
• Job requires 40 hours per week with shift flexibility between the hours of 8am-9pm est
• Bilingual or multilingual a plus

• Requires being at a desk for extended periods of time
• Requires being on the phone with patients, insurance companies, providers and others throughout the day.