Wellness Advisor

Bailey Finch Associates are delighted to assist their client with the role of Wellness Advisor - Weymouth

Primary Responsibilities:

•    Manage administrative intake of members or the admission/discharge information post notification
•    Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers
•    Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
•    Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage.
•    Review requests for adverse determination, approval notification and processing notification requirements
•    Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

Handle resolution/inquiries from members and/or providers that may include:
•    Benefit and Eligibility information
•    Billing and Payment issues
•    Customer material requests
•    Physician assignments
•    Authorization for treatment

Taking calls into the service, recording core data, completing assessment questionnaires.Signposting to other services making follow up calls and general related administrative duties.
Experience using data bases and IT literate. Good customer service skills.
Required Qualifications:

•    2+ years of customer service experience analyzing and solving customer problems
•    Must be able to create, edit, save and send documents utilizing Microsoft Word and Excel
•    Must be able to navigate a PC to open applications, send emails, and conduct data entry

Preferred Qualifications:

•    Experience working within the Healthcare Industry
•    Experience working with Healthcare Insurance
•    Experience working in a Hospital, Physician's Office, or Medical Clinical setting
•    Professional experience in a clerical or administrative support related role
•    Working Knowledge of Medical Terminology to communicate with members and providers

If this sounds of interest to you, please forward your cv in the first instance to Bailey Finch Associates who are acting as a recruitment agency with this vacancy.