Experienced Inbound/Outbound Queue Associate – Medical Services Coordination and Customer Support Specialist

Introduction to Workwarp and Our Mission

At Workwarp, we are dedicated to delivering exceptional customer experiences and supporting the well-being of our community. As a leader in the healthcare industry, we strive to make a positive impact on people's lives. Our purpose is built around bringing heart to every moment of healthcare, and we are committed to providing personalized, convenient, and affordable services. We believe that our Heart At Work Behaviors are essential in transforming our culture and driving innovation. If you are passionate about making a difference and are looking for a challenging and rewarding role, we encourage you to join our team as an Inbound/Outbound Queue Associate.

Job Overview

This is a hybrid role that offers the flexibility of working from both our office location and a designated virtual work location. As an Inbound/Outbound Queue Associate, you will play a vital role in coordinating medical services, including intake, screening, and referrals to Aetna Better Health. Your responsibilities will include promoting the quality effectiveness of healthcare services, performing intake calls, utilizing Aetna systems to manage member information, and maintaining accurate documentation. You will also be responsible for communicating with Aetna Case Managers, supporting the administration of the precertification process, and placing outbound calls to providers to obtain clinical information.

Key Responsibilities:

• Promote and support the quality effectiveness of healthcare services
• Perform intake of calls from members or providers regarding services via telephone, fax, or EDI
• Utilize Aetna systems to build, research, and enter member information
• Screen requests for appropriate referral to medical services staff
• Approve services that do not require a medical review in accordance with the benefit plan
• Perform non-medical research, including eligibility verification, COB, and benefits verification
• Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
• Promote communication, both internally and externally, to enhance the effectiveness of medical management services
• Protect the confidentiality of member information and adhere to company policies regarding confidentiality
• Communicate with Aetna Case Managers, Aetna Nurses, and Medical Directors when processing transactions for members active in this Program
• Support the administration of the precertification process in compliance with various laws and regulations and/or NCQA standards, where applicable
• Place outbound calls to providers to provide information or obtain clinical information for approval of medical authorizations

Requirements and Qualifications

To be successful in this role, you will need to have:

Essential Qualifications:

• 1+ years of experience working as a medical assistant, office assistant, or other clinical/equivalent experience
• High School Diploma or equivalent GED

Preferred Qualifications:

• 1+ years of call center experience
• 1+ years of prior authorization experience
• Associate's degree

You should also possess excellent communication and interpersonal skills, with the ability to work in a fast-paced environment and prioritize multiple tasks. Proficiency in Aetna systems, such as MedCompass, QNXT, ProFAX, and ProPAT, is desirable.

Skills and Competencies

To excel in this role, you will need to demonstrate:

• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work in a fast-paced environment and prioritize multiple tasks
• Proficiency in Aetna systems, such as MedCompass, QNXT, ProFAX, and ProPAT
• Strong attention to detail and ability to maintain accurate documentation
• Ability to protect the confidentiality of member information and adhere to company policies regarding confidentiality

Career Growth and Learning Benefits

At Workwarp, we are committed to supporting the growth and development of our employees. As an Inbound/Outbound Queue Associate, you will have access to:

• Comprehensive training programs to enhance your skills and knowledge
• Opportunities for career advancement and professional growth
• A supportive and collaborative work environment that encourages innovation and creativity
• Recognition and reward programs to acknowledge your achievements and contributions

Work Environment and Company Culture

Our company culture is built around our Heart At Work Behaviors, which include:

• Bringing our heart to every moment of healthcare
• Empowering our colleagues to make a positive impact
• Driving innovation and delivering personalized, convenient, and affordable services
• Supporting the well-being of our community and making a difference in people's lives

We offer a dynamic and inclusive work environment that values diversity, equity, and inclusion. Our employees are passionate about making a difference, and we encourage a culture of collaboration, creativity, and innovation.

Compensation, Perks, and Benefits

We offer a competitive salary range of $17.00 - $25.65 per hour, depending on experience and qualifications. In addition to your compensation, you will be eligible for a range of benefits, including:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Term life insurance plan
• Short-term and long-term disability benefits
• Well-being programs and education assistance
• CVS store discount and discount programs with participating partners
• Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year

Conclusion

If you are a motivated and compassionate individual who is passionate about making a difference in healthcare, we encourage you to apply for this exciting opportunity. As an Inbound/Outbound Queue Associate, you will play a vital role in coordinating medical services and supporting the well-being of our community. Don't miss out on this chance to join our team and be part of a company that is dedicated to delivering exceptional customer experiences and making a positive impact on people's lives. Apply now and let's discuss how you can become a vital part of our success story.

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