Sayra Perez Nieves

This position supports case management and other related programs. Working directly with the integrated behavioral health and case management team will provide outreach to patients of the Providence Community Health Centers. Outreach includes, but is not limited to, clinic visits, and telephonic outreach. As a member of the local community, the community health workers behavioral health will assist the integrated behavioral health care team by providing care coordination, community resources, Spanish-language interpretation, assist with appointments, as well as closing gaps regarding social barriers (food, housing resources, utilities etc.). Development of one-on-one relationship in collaboration with integrated behavioral health clinician and specific care team provides an opportunity to remove social barriers and assist the member to live a healthier life while supporting a culturally diverse community.

Insurance Enrollment Specialist will provide information to consumers regarding the ACA as it relates to the health insurance coverage options for Rhode Islanders. This information includes: Program eligibility: rules to purchase subsidized insurance through the Exchange and eligibility for Medicaid, Medicare or other programs. Methods of purchase: provide information concerning enrollment in QHPs, premium tax credits, and cost-sharing reductions. Explaining definitions of health insurance terms, for example, aiding the consumer to understand the difference between a premium, deductible and co-insurance. Answering enrollment questions and addressing questions regarding access to any of the enrollment methods and the submission of enrollment documentation to the Exchange. Explaining eligibility criteria for purchasing insurance through the Exchange, enrolling in Medicaid and other State programs designed to provide medical coverage.
Furnishing unbiased explanations of coverage provided on the Exchange portal without offering any opinion or editorial on the QHPs in the Exchange.
Providing the consumer with documentation regarding the available plans, enrollment letters stating the date coverage will start, etc. Providing information to the consumer to find avenues to resolve disputes with carriers.
Reach out to uninsured by phone, attendance at community events, in person at Health Center sites to enroll them in insurance programs. Update database of uninsured with each contact made and enrollment complete. Facilitate enrollment in QHPs; Provide culturally and linguistically appropriate health insurance enrollment assistance for Hispanics, Asians, Native Americans, those with disabilities and other groups.

PSR
Greets, interviews, registers, and exits patient. Verifies identity and financial information for scheduled patients. Completes all required fields of information in the automated practice management system. This pertains to any specialty clinics located at that site, as well. Provides coverage support to the clinic's call center when needed. Schedules patients in daily provider schedules. Maintains physician appointment schedules within guidelines.
Provides front desk phone support for incoming or outgoing calls. Processes payment for services. Assists in the processing of mail and faxes as needed.
Provides communication services within the health center and between the health center and the patient community. Functions as interpreter/cultural broker when filling a bilingual position.

Customer Service Associate provides customer support by phone, email, or instant message to consumers. Serves as primary contact for inbound customer issues. Escalates more technical product-related issues to the proper Product Support department. Processes a high volume of consumer inquiries of FIS products and services and resolves a targeted percentage of those inquiries. Troubleshoots customer problems, identifies the root cause of the problem, and uses tool and resources appropriately to determine how to resolve customer problems. When unable to resolve the problem in a reasonable amount of time, will escalate to the appropriate resource. Follows up on escalated issues with coaching and mentoring to learn the appropriate solution and expand overall knowledge. Tracks and documents inbound support requests and ensures proper notation of customer problems or issues. Updates customer information and ensures accurate entry of contact information. Meets the standards of the job, such as quality standards, adherence to schedule, and average handle time. May provide guidance and/or mentoring to less experienced Customer Service Associates - Consumer.