Support Specialist (HYBIRD)
Nashville, TN

Role Summary

Daily role responsibilities:

The Support Specialist supports the multidisciplinary care team by ensuring seamless delivery of the Narus program for individuals and their families by providing the following services:

• Providing an excellent member experience through direct communication through high volume inbound and outbound calls and secure messages.
• General Support Specialist duties including:
  1. Educate members on benefits plans including items such as: deductibles, in/out of network inquiries and other benefit questions.
  2. Assist in preventing and/or resolving delay in care by educating providers/facilities on RBP insurance.
  3. Confirm the deployment and receipt of ancillary services such as home health, DME, radiology, and community based social services.
  4. Aid and resolve patient issues regarding locating accepting providers. 
  5. Maintain case load in a timely manner. 
• Perform appropriate triage and escalation of routine and urgent patient calls to the clinical team when appropriate.
• Calls external facilities and providers to execute on care plan issues for patients.
• Make outbound patient calls to coordinate non-clinical patient needs.
• Assist care team with locating community resources for our patients.
• Assist office-based team with faxing, documentation, and telephonic/virtual support of care management priorities.
• Participate in weekly team meetings and bi-weekly one on ones.

This position could be a good fit if you have:

• A minimum of two (2) years of related experience or equivalent, preferably in a physician office or clinical call center.
• High school diploma required. 
• 1 week in-office training required in Nashville, TN. 
• Patient, compassionate, and professional personality with a strong service orientation. 
• Demonstrated problem solving skills.
• Proficient on Microsoft Office programs, EMR/Care Management platforms, and keyboarding.
• Demonstrated knowledge of legal and ethical issues related to confidentiality, including HIPAA and state specific privacy laws.

• Knowledge of Reference-based pricing (RBP) and understanding the relationship between self-funded insurances and third-party administrators preferred. 
• Understanding of insurance benefits included deductible, out of pocket, copays, etc. 
• Commitment to excellence and high standards.
• Ability to analyze complex data, draw conclusions, and act on that information in a timely manner.
• Ability to apply problem-solving techniques to the case management process.
• Excellent time management, flexibility, and organizational skills with the ability to work independently.
• Critical thinking and good judgement to quickly determine and prioritize issues.
• Good communication, teamwork, and interpersonal skills with the ability to work with all levels of management.
• Prior telephonic patient engagement or care coordination experience required.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. 

Physical and Mental Requirements: 

The physical demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to do the following:

• Coordinate multiple tasks simultaneously
• Understand and respond to a diverse population
• Perform some repetitive motion activities
• Sit for extended periods of time 
• Required close vision and the ability to adjust eye focus often
• Required to communicate vocally and hear using a standard telephone device
• Required to reach with hands and arms
• Requires minimal weight to be lifted (not more than 10 pounds) or force exerted on a regular basis.
• Requires additional weight to be lifted upon issuance and/or removal of computer equipment (up to 40 pounds)
• Required to communicate electronically
• Occasionally required to stoop, kneel, crouch, and crawl

Work Environment:

The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee will not regularly work in wet or humid conditions, endure extreme cold or heat or outdoor (non-weather) unless they are traveling between work sites. The employee will not function near moving mechanical parts, or work in high, precarious places
• Noise Level – The noise level in the employee's work environment is usually quiet to moderate
• Travel – Regular business-related travel is not required for this position

Benefits:

We offer a competitive, comprehensive benefits package that includes Health, Dental and Vision Insurance, Employer-paid Life, Supplemental Life and AD&D, Voluntary STD, Accident, and Critical Care Insurance, discounted Auto, Home, Renter, and Condo Insurance, Wellness, EAP Services, Paid Training, and Paid Vacation and Holidays.

AN EQUAL OPPORTUNITY EMPLOYER