Customer Service Advocate I

Immediate need for a talented Customer Service Advocate I. This is a 12 months contract opportunity with long-term potential and is located in Woodland Hills, CA (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:24-40384

Pay Range: $19 - $19.64/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• If you are interested in this position, please forward your updated resume for immediate consideration and preferred time to discuss this opportunity further.
• Since the client has requested for a bilingual candidate , kindly complete the required Spanish test as well.
• Link to the Spanish test: https://hire.glider.ai/connect/51454171

• Shift: anywhere between 9:30am-6pm M-F.Training hours are 8am-4:30pm M-F. Training is approximately 5-6 weeks. Must be available for some Saturday trainings.
• Member outreach calls, appointment linkage, community resource connections, social determinants of health follow up, provider calls.
• Research claims inquiry specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results.
• Assess and monitor inpatient census.
• Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services.
• Screen members by priority for case management (CM) assessment.
• Perform transition of care duties to include but not limited to contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
• Coordinate services with community-based organizations.
• Attend marketing and outreach meetings as directed to represent the plan.
• Produces and mails routine CM letters and program educational material.
• Data enter assessments and authorizations into the system.
• Performance expectations/metrics is 40 calls per day reaching out to the members assigned to the Program Coordinator I.
• Metrics must be met weekly to meet the expectation that is set by the department.
• Trainings through Client University, 4 to 6 weeks of training, and trainings with the hire manager and department for the role they are hired to do as a program coordinator.

Key Requirements and Technology Experience:

• Key Skills: Call center, customer service, inbound and outbound calls.
• High school diploma or equivalent.
• 2-3 years managed care setting, medical office or facility setting with demonstration of medical administration duties.
• Thorough knowledge of customer service, utilization review or claims processing practices in a managed care.
• Microsoft Word, Excel, Outlook.

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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