Job Information
G-TECH Services, Inc. Precertification Specialist in Detroit, Michigan
Required Skills and Experience:
Medical Terminology or medical background such as nursing assistant/tech or doctor office experience
Customer Service experience
Exceptional phone skills
Administrative/PC skills
Education: beyond high school diploma
Highly preferred:
Provide high quality, member focused servicing using knowledge of plans, products, systems, and procedures to meet or exceed member experience
Assist in locating primary care physicians, specialists and dentists
Thoroughly explain wellness care management program benefits to members
Work as a team member to assist nurses in researching providers, eldercare, nursing homes
Concisely and accurately enter documentation into Care Advance
Effectively engage over the phone via both inbound and outbound members that qualify for our clinical programs or those who are interested in learning more about our services
Refer and/or warm transfer to wellness and care management components and other BCBSM areas and vendors as needed
Process provider requests as needed
Act as member's first trusted source for WCM programs
Schedule appointments between the member and coach in appropriate systems
Assign referrals to designated staff
Process requests for compliance inquiries
Access various WCM department mailboxes and voicemail as needed
Ability to function independently
Critical Thinking
Quick learner
Bi-Lingual/Spanish
Category Clerical
Function Clerical / Administrative
Req ID JN -052024-121194