Case Resolution Specialist I

FreedomCare•Philadelphia, PA

1d•Remote

About The Position

The Case Resolution Specialist I role is a customer-centric role that will partner with patients and health plans to identify issues preventing the patient from continuing services. This team also assists any former patient who is looking to return to the agency with restoring their homecare services. This role combines the intake and onboarding activities for both patients and caregivers and provides one point of contact consumer experience in their transition back our program.

Requirements

Experience in managing a high volume of inbound and outbound calls
A passion for providing a high level of customer service, including the ability to show empathy, active listening and patience
Ability to articulate case statuses through detailed notes on salesforce
Computer proficiency required; strong typing skills and ability to leverage technology and resolve customer issues
Previous experience in a Customer Service environment.
High-volume inbound call center or contact center environment (at least 2 years).
Experience with CRMs such as Salesforce
Ability to organize, set priorities and manage time effectively.
Strong verbal and written communication skills, demonstrating active listening and adaptability to different personality types.
Ability to resolve issues over the telephone with eager customers comfortably, defusing and de-escalation frustrated callers successfully.
Attention to detail in reviewing records.
Ability to meet and/or exceed targets or metrics.
Computer proficiency required; strong typing skills and ability to leverage technology and resolve customer issues efficiently while notetaking/multitasking

Nice To Haves

2 years of relevant experience in a similar position is preferred
Bilingual in Spanish, or other languages desired
Salesforce proficiency
Familiarity with Pennsylvania Medicaid & health plan experience

Responsibilities

Provide high-level customer service through one-call resolution, as measured by “no need for additional follow up” demonstrating Freedom Care's values of ensuring care and compassion with a positive, helpful demeanor
Consistently meets monthly performance metrics of starting patients on Care and call handling
Act as the primary point of contact for all Patients and Caregivers restoring their services, coaching them through the application & enrollment process of the program
Demonstrate effective case management by maintaining a 1 business day email, chatter and voicemail response time
Achieve monthly standard to enroll a minimum of 22 patients and caregivers onto FreedomCare’s Pennsylvania homecare program
Maintain high quality of customer service on all inbound & outbound calls with potential patients & caregivers
Navigate multiple systems, such as e-Paces & health plan portals to determine eligibility and obtain authorization
Maintain detailed patient and caregiver case notes
Focus on the growth of FreedomCare population by enrolling each valid lead with interest
Align consumers with caregivers looking for additional hours
Assist both patients & caregivers with completing the process to restore services
Communicate with patients, caregivers & health plans to ensure that the process is completed
Consistently reach out to patients to provide updates and ensure that they are aware of the status of the process
Work cross-functionally with Intake, Care Teams, and all other necessary departments to ensure that patients/caregivers are engaged and getting the most value out of our services
Meet daily, weekly & monthly metrics & call requirements to ensure patients can resume services
Assist patients with troubleshooting & resolving any Medicaid related issues.
Educate patients & caregivers about the onboarding process
Work with health plans to obtain authorizations & ensure all necessary paperwork is on file & up to date
Provides necessary documentation and requirements with Pennsylvania's State Department of Health, patients' insurance and the Patient’s Caregivers to ensure services are authorized in a quick and efficient turn-around time to get them on Care
Work with other medical providers to ensure all documentation for potential patients and caregivers is in compliance