Precertification Specialist

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING Strategic Staffing Solutions is currently looking for a Bilingual Precertification Specialist for a contract opportunity with one of our largest clients located in Detroit, MI Title: Precertification Specialist Location:

Detroit, MI (Work from home) Must be local to Detroit, MI for consideration. Duration: 12 Months Role Type: W2 Contract Engagement Rate: $18/hr Must be within a reasonable proximity to Detroit. Anticipated work hours vary between 8:00a.m. - 8:00p.m. (to include rotating Saturdays, holidays, and overtime as needed). 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 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 client 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 • Bi-Lingual/Spanish