Charitee Childress

• Predominate amount of work surrounding calling members to inform them of their Specialist Management Solutions benefits and acts as a care guide on behalf of the customer helping them receive treatment from a network of high-quality surgeons

• Receives inbound calls from members to educate them on their Specialist Management Solutions benefits and provide guidance with appointment scheduling

• Assists in the coordination of care across a variety of settings, while maintaining strict confidentiality and the highest level of professionalism

• Updates all systems accordingly to document member engagement

• Accurately documents appointments and updates information accordingly.

• Listens to member’s comments, concerns, and suggestions, relaying that information internally, while ensuring member satisfaction

• Collaborates with other departments and partnering companies as necessary

• Works with health insurance counterparts to answer customer questions related to benefits, claims, and billing

• Addresses and analyzes member inquiries, concerns, and complaints while providing information/solutions.

• Works within a team to achieve performance targets

• Achieves individual Performance Metrics and Goals

• Adheres to attendance policy and expectations

• Participates in ongoing training and development

• Other responsibilities as assigned

• Received inbound calls in a call center environment from providers, health

plans and patients.

• Issued referrals to specialists.

• Utilized engagement strategies to build rapport.

• Accurately documented information received from members, provider offices,

and health plan clients into New Century Health’s online clinical system.

• Performed clerical duties such as faxing and scanning documents, created

shipping labels, prepared letters and parcels using office machines, such as

printers, photocopies, scanners, facsimile machines, telephone and voice.

• Mailed systems and computer-based programs such as Microsoft Office.

• Supported UM functions by performing activities that did not require evaluation

or interpretation of clinical information.

• Responded to a high-volume of incoming and outgoing telephone calls and faxed referral.

• Coordinated care by scheduling, editing and maintained routine patient physician appointments

for new and returning patients.

• Facilitated communication between the patient and the physician or clinic.

• Delivered expert knowledge regarding clinic-specific processes.

• Accurately documented and routed calls to the proper department.

• Identified urgent customer needs or operational issues, and escalated appropriately.

• Worked with care teams, patients, and outside facilities to obtain necessary information

required for care.

• Communicated with the care team and supported staff on various patient issues.

• Obtained and updated insurance information.

• Met all regulatory and compliance standards.

• Delivered high-level of customer service.

• Followed documented protocols and guidelines.

• Met and exceeded departmental quality assurance standards.

• Used reference documents and online knowledgebase tools to clearly articulate accurate

information regarding services.

• Used functionality of the telephone system as required.

• Other departmental duties as assigned.