HMO Specialist I at Nemours in Jacksonville, Florida

Job Description:

Nemours is seeking an HMO Specialist I to join our Nemours Children's Health team in Jacksonville, FL.

Primary Function:

Greet patients in accordance with Nemours Standards of Behavior. Obtain authorization for scheduled visit by following the NCC Standard of Business Practice. Verify and update demographic, insurance, PCP and authorizations/referral information when required at each encounter.

Essential Functions:

1.Assist patients in obtaining an authorization when they arrive at the clinic without an appropriate authoization and advise clinic of patient status.

2.Communicate with assigned clinics regarding unattainable authorizations.

3.Monitor voice mail and return calls as appropriate for the main HMO phone line.

4.Workqueues: Process encounters via the DAG workqueue daily.

5.All other duties as assigned by supervisor or manager.

Requirements:

HS Diploma or equivalent required. One year of specialized training beyond HS required.

Customer Service and HC experience preferred

One to three years experience in medical offices/call center

Excellent written and verbal communication, Multi-tasking, Critical Thinking, Excellent customer service Skills.