evry-health - Care Guide Advocate

Remote - CT (Central)2mo ago

Remote Mid NA K-12 Education Public Sector Associate Support Specialist Physician Medical Records Documentation

Requirements

• High school diploma • 2-3 years in customer service • Strong computer skills and experience with electronic medical records • Intermediate knowledge of Microsoft Windows • Exceptional verbal and written communication skills • Ability to work effectively and flexibly in a fast-paced environment with competing priorities • Experience with medical office/customer support. • Associate’s degree in medical field. • ## Work Environment • This is a fully remote position. Candidates must reside in the United States within the Central (CST) or Eastern (EST) time zone. • Standard business hours are Monday through Friday, 9:00 AM – 5:00 PM CST, with occasional flexibility required to meet regulatory response deadlines. • Must maintain a dedicated, private workspace that is separate from other living areas and supports the secure handling of confidential information. • Must have a reliable high-speed internet connection. • All company-sensitive documents must be kept secure and handled in accordance with Evry Health data privacy and security policies.

Responsibilities

• Provide a high degree of customer service and professionalism when interacting with the patients of providers via the phone or email; ability to empathize and diffuse difficult situations professionally and in a caring manner • Assist members with detailed provider searches utilizing network look-up tools • Assist members navigating our digital programs and serve as a conduit for escalations and questions • Contact provider offices or facilities to obtain needed prior authorization pieces such as additional medical records, forms, facility location or Tax ID numbers for claims billing • Assist with claims work such as adjusting site of service • Protect/observe patient privacy and confidentiality, per external regulatory requirements (HIPAA) and internal policy and procedures • Ensures compliance with applicable URAC and NCQA accreditation guidelines and state and federal regulations