2 days ago Be among the first 25 applicants
This range is provided by CareBridge. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $19.00/hr - $31.09/hr
Location: Virtual in California. This role enables associates to work virtually full‑time in California, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development.
Hours: Monday – Friday, an 8‑hour shift between 8 am & 5 pm PST.
Responsibilities Managing incoming calls.
Determine contract and benefit eligibility; creates authorizations for LTSS members.
Obtains intake (demographic) information from LTSS providers.
Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.
Processes incoming requests; collection of information needed for review from providers.
Verifies benefits and/or eligibility information.
May act as a liaison between LTSS and internal departments.
Responds to telephone and written inquiries from providers and in‑house departments.
Manages non‑clinical needs of members with chronic illnesses, co‑morbidities, and/or disabilities, to ensure cost effective and efficient utilisation of long‑term services and supports.
May also serve as a mentor, subject‑matter expert or preceptor for new staff, assisting the formal training of associates, and may be involved in process improvement initiatives.
Minimum Requirements Requires HS diploma or equivalent and a minimum of 2 years customer service experience in a healthcare‑related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities And Qualifications For URAC accredited areas, the following professional competencies apply: strong oral, written and interpersonal communication skills, problem‑solving skills, facilitation skills, and analytical skills.
Previous experience working in a social work setting preferred.
BA/BS degree is preferred in the field of health care.
Specific education, years and type of experience may be required based on state law and contract requirements.
Travel to worksite and other locations when necessary.