Care Advocate - Columbia, SC

CHS • Columbia, SC

15h • Remote

About The Position

The Care Advocate position, located in Columbia, SC, is a telephonic, work-from-home position with occasional travel required. Mileage is reimbursed. The Care Advocate is a non-clinical position that assists the clinical staff in supporting members with acute and chronic clinical conditions for the Medically Complex Children’s Waiver program in South Carolina.

Requirements

• A minimum of two (2) years of work experience as a Certified Nurse Assistant, Medical Assistant or Medical Administrative assistant preferred.
• Proficiency in data entry skills
• Strong customer service/telephone skills
• Bilingual (Spanish) preferred
• Ability to travel locally with a valid drivers' license and automobile insurance
• A high school diploma or equivalent is required.
• Knowledge of medical terminology is required.
• Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook

Nice To Haves

• A minimum of two (2) years of work experience as a Certified Nurse Assistant, Medical Assistant or Medical Administrative assistant preferred.
• Bilingual (Spanish) preferred

Responsibilities

• Maintains and ensures the confidentiality of all Personal Health Information (PHI) collected
• Serves as a member advocate, providing support, triage and referral access to the clinical staff
• Participates in all client specific program, process and quality training programs
• Documents information into Phoenix as directed by the nursing staff. Utilizes Phoenix (SCDHHS controlled software) and provides documentation in Phoenix (SCDHHS controlled software) as directed
• Places outreach calls to members/responsible parties for coordination, scheduling, collecting demographic/non-clinical information, referrals, DME requests, and other ancillary provider requests, as directed by nursing staff
• Answers incoming calls requesting services
• Uses reason and logic to solve problems during the review process and maintains a positive, professional and respectful attitude with peers and clients
• Reviews and analyzes claims data in accordance with coordination for financial reports
• Attends home visits as needed to support the nurses.
• Coordinates Team Conference dates for nurses with local physician offices.
• Verifies Medicaid eligibility on participants and assists participants to maintain eligibility.
• Verifies participant demographics and enters them into the Phoenix system.
• Work with participants and DHHS to obtain the state Medicaid plan services; CPDN, CPCA, IS.
• Assist participants with referrals to outside services such as babynet and transportation services.
• Assist Care Coordinators to obtain paperwork from providers such as physician orders and nursing notes.
• Report insurance changes to the Medicaid system.
• Assist the Team Leads complete report documents for staff productivity.
• Organize agendas for staff meetings under program manager supervision and coordinate lunches for those meetings.
• Sending out sympathy cards for deceased members to families.
• Provider marketing assistance for the program as directed by program manager.
• Adheres to the policies and procedures of Community Health Solutions
• Maintains strict confidentiality of client, company and personnel information
• Demonstrates a strong commitment to the mission and values of the organization
• Adheres to company attendance standards
• Performs other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED