Blue Cross Blue Shield of Arizona
Phoenix, Arizona, United States
Medicare Member Outreach Representative - Remote (AZ)
Job Description
Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
The remote work opportunity requires residency, and work to be performed within the State of Arizona.
PURPOSE OF THE JOB
This position performs activities related to closing member healthcare and quality gaps/deficits through outbound telephone member outreach, coordinating member appointments with their primary care providers office, and requesting contracted outbound call center or Home Assessment staff to engage in direct member intervention.
QUALIFICATIONS
REQUIRED QUALIFICATIONS
Required Work Experience
1 year of general administrative, clerical, or customer service experience in a healthcare organization or a primary healthcare practitioners office
Required Education
High School diploma or GED in general field of study.
Required Licenses
N/A
Required Certifications
N/A
PREFERRED QUALIFICATIONS
Preferred Work Experience
N/A
Preferred Education
Education or training in the basics of medical terminology, medical record documentation, and common ICD, HCPCS, CPT codes
Preferred Licenses
N/A
Preferred Certifications
N/A
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
Follows a standard outbound call script and places outbound calls to members
Explains the importance of receiving an Annual Wellness Visit and/or physical examination from their primary care provider to members
Informs members of healthcare gaps that should be addressed by visiting their primary care provider
Provides other preventive medicine and educational information to members
Coordinates member appointments for AWVs/physical examination through 3-way telephone communication (i.e., Member Outreach Technician, member, and primary care provider)
Completes all daily outbound call assignments and meets all outbound call, quality improvement, and gap closure productivity standards for outreach activities
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards
The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
Perform all other duties as assigned.
COMPETENCIES
REQUIRED COMPETENCIES
Required Job Skills
Knowledge and experience in application of marketing techniques aimed at consumer populations
Knowledge of reporting and information presentation
Computer proficiency in a MS-Windows environment, including MS Word and Excel, and ability to learn organizational systems and software applications
Required Professional Competencies
Ability to effectively communicate with health care providers and staff, patients, and co-workers.
Strong organizational skills
Provides excellent customer service by consistently demonstrating the BCBSAZ core values
Required Leadership Experience and Competencies
N/A
PREFERRED COMPETENCIES
Preferred Job Skills
Basic knowledge and understanding of primary care provider office practices, appointment setting, medical records management and billing processes
Bilingual in English/Spanish
Preferred Professional Competencies
N/A
Preferred Leadership Experience and Competencies
N/A
CORPORATE RESPONSIBILITIES
Comply with BCBSAZ corporate and departmental policies and procedures, including, but not limited to Code Blue, Compliance, HIPAA, Computer Responsibility, Accreditation Standards, Attendance, Staff Qualifications, and Quality Management Accountabilities.
Our Commitment
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.