At WelbeHealth, we make the impossible, possible for underserved seniors. We do this through utilizing and developing cutting-edge healthcare and well-being service products especially for seniors and their families. Now is your chance to join our talented team that delivers unparalleled creative healthcare, insurance, social support and more to seniors. We create senior well-being through our courage to love, pioneering spirit and shared intention. These values permeate everything we do. At WelbeHealth, you’ll help inspire that magic by enabling our teams to push the limits of healthcare and well-being experiences and create the never-before-seen!
Reporting to the Sr. Manager of Health Plan Operations, the Call Center Representative will be responsible for timely and accurate scheduling, authorization entry, and tracking all participant care appointments that may occur with WelbeHealth PACE team members, at home, or with network provider partners. The Call Center Representative will ensure authorizations are completed and entered into Health Plan software in a timely manner. Communicate with transportation team and participants, family and caregivers to ensure proper transportation is set for any future visits and appointments. The Call Center Representative will be a key stakeholder in updating WelbeHealth team members and participants, family and caregivers for any changes in appointments or scheduling.
What you’ll do:
- Schedule all participant appointment requests (direct and via orders and ticklers in the EMR) for WelbeHealth PACE team members, home providers, and network provider partners
- When required for network partners, enter timely and accurate authorizations in the Health Plan software system to support accurate and timely payment for services
- Communicate with all stakeholders (participants, team members, family, partners etc.) to confirm schedule and authorization status, update in event of changes, and troubleshoot problems to resolve in a timely manner with excellent customer service
- Meet established turnaround time and accuracy service levels for scheduling and authorization entry
- Ensure accuracy of initial EMR order entry for internal and external appointments, obtaining additional information from ordering providers as needed
- Triage orders needing follow-up or pending results and trouble-shoot as needed to resolve – clarifying orders, requesting additional records, etc.
- Provide touchpoints, reminders, and instructions for participants and team members as needed to ensure a successful experience from initial request to return of results
- Maintain current and accurate records of all scheduled appointments – scheduled times, outcomes (e.g. appointment occurred or not, reasons for rescheduling)
- Respond to all COSA line inquiries, addressing participant and provider questions, escalate urgent matters to COSA supervision
Why you’ll love working at WelbeHealth:
- You will play a critical role in bringing the ground-breaking WelbeHealth PACE model of care to scale, providing much needed services to a vulnerable population
- You’ll be joining a company that combines the best of mission-driven orientation with innovation, with the opportunity to help shape our programs and processes as we grow
- You’ll be surrounded by capable colleagues who care deeply about their work and are greater than the sum of our parts
- Strong preference for those who have completed 2-step COVID-19 vaccination series or are willing to do so in first 30 days after hire as condition of continued employment
- Preference for Southern California based team members, who would be open to potentially work on-site within our markets in the future, dependent on the business and operational need.
- High school diploma or equivalent, required
- Graduation from a 2-year associate degree program in medical assistance accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), preferred
- 2 years experience as a Medical Scheduler in a skilled senior care facility, physician office or medical clinic preferred
- 2 years experience working with Electronic Medical Records, preferred
- Bilingual speaker preferred
- Outstanding customer service orientation, especially in telephone and written communications
- Deep commitment to helping unlock the potential of our most vulnerable seniors.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all of our employees and proof of vaccination prior to employment is required.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.