Care Advocate

Community Health Solutions Of America • Columbia, SC

268d • Remote

About The Position

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. This is a work-from-home position within a designated South Carolina territory community. Applicants must live in the State of South Carolina.

Requirements

• A minimum of two (2) years of work experience in a medical office setting
• Proficiency in data entry skills
• Strong customer service/telephone skills
• Medicaid experience a plus
• Bilingual (Spanish) preferred
• A high school diploma or equivalent is required
• Knowledge of medical terminology is required
• Proficiency using software programs such as MS Word, Adobe, Gmail, Excel and Outlook

Nice To Haves

• Certified Medical Assistant
• Certified Community Health Workers

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 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
• Assists providers' offices with member specific missed appointments through member outreach and scheduling, as well as assisting care coordinators with scheduling all visits
• Answers incoming calls requesting services
• Participates in the collection and reporting of information as defined by the monthly reporting requirements
• Uses reason and logic to solve problems during the review process and maintains a positive, professional, and respectful attitude with peers and clients
• Researches and secures new telephone numbers to contact members
• Reviews and analyzes claims data in accordance with coordination for financial reports
• Works with clinical staff in the performance of all non-clinical/administrative tasks associated with the MCCW program
• If bilingual (primarily Spanish), assist with translation calls with care coordinators
• Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITEC)
• 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

• Industry: Professional, Scientific, and Technical Services
• Education Level: High school or GED