Clinical Specialist Jobs

About The Position

Requirements

• High School Diploma or equivalent required
• A minimum 1-year experience working in an office setting as a receptionist, telephone customer service representative, or telemarketing representative required.
• Good communication skills via telephone with members, customers, peers and superiors
• Basic Competency Level in: Excellent interpersonal skills
• Basic Competency Level in: Ability to understand and interpret policy provisions.
• Basic Competency Level in: Product knowledge
• Basic Competency Level in: Typing Skills
• Basic Competency Level in: Problem Solving Skills
• Basic Competency Level in: Proficient computer skills
• Basic Competency Level in: Demonstrates empathy
• Moderate Competency Level in: Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible
• Moderate Competency Level in: Ability to assist member in navigating the healthcare system and community-based resources
• Moderate Competency Level in: Culturally sensitive and competent for assigned membership
• Moderate Competency Level in: Strong organizational skills; ability to multi-task and be nimble
• Moderate Competency Level in: Ability to work remotely
• Moderate Competency Level in: Ability to determine when to escalate issues appropriately and in a timely manner

Nice To Haves

• Direct experience in a telehealth support function preferred.

Responsibilities

• May work in multiple products receiving inbound calls from members, physicians, clients and others to process requests per Sagility LLC policies and guidelines
• May work in multiple products conducting outbound call projects to members for enrollment purposes, customer satisfaction surveys, and other outbound projects
• Routes messages to appropriate nurse and makes pertinent notes in patient charts when necessary.
• Ensures that notes are clear and timely
• Uses applications according to policies and guidelines to ensure quality delivery of services.
• Maintains a mutually effective working relationship with callers, physician offices, clients, team members, supervisors, and internal customers
• Maintains confidentiality of all patients according to HIPAA standards.
• Collects and validates patient demographic information including insurance type and patient contact information
• Obtains pre-certification or authorization numbers if necessary for referral
• Regular, reliable attendance and timeliness
• Other duties as assigned