Case Resolution Specialist I

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We’re the largest consumer-directed home care agency in NY State, and are continually expanding our areas of focus including operations in other states and tech-based innovations.
We pride ourselves on our values which drive the level of care that we deliver to our patients:
Here For You (An attitude of service, empathy, and availability)
Own It (Drive and ownership)
Do the Right Thing (High integrity)
Be Positive (Great attitude and a can-do positive approach to challenges)
Join our team and make a positive impact on the lives of others! We are looking for an Case Resolution Specialist I for our team in Pennsylvania.
This is a field-based position with a required commute of 2-3 days per week into our Pittsburg office.
Department & Position Overview:
The Case Resolution Specialist I role is a customer-centric role will partner with patients and health plans to identify issues preventing the patient from continuing services. This team also assists any former patient who is looking to return to the agency with restoring their homecare services. This role combines the intake and onboarding activities for both patients and caregivers and provides one point of contact consumer experience in their transition back our program.
Responsibilities:
Provide high-level customer service through one-call resolution, as measured by “no need for additional follow up” demonstrating Freedom Care's values of ensuring care and compassion with a positive, helpful demeanor
Consistently meets monthly performance metrics of starting patients on Care and call handling
Act as the primary point of contact for all Patients and Caregivers restoring their services, coaching them through the application & enrollment process of the program
Demonstrate effective case management by maintaining a 1 business day email, chatter and voicemail response time
Achieve monthly standard to enroll a minimum of 22 patients and caregivers onto FreedomCare’s Pennsylvania homecare program
Maintain high quality of customer service on all inbound & outbound calls with potential patients & caregivers
Navigate multiple systems, such as e-Paces & health plan portals to determine eligibility and obtain authorization
Maintain detailed patient and caregiver case notes
Focus on the growth of FreedomCare population by enrolling each valid lead with interest
Align consumers with caregivers looking for additional hours
Assist both patients & caregivers with completing the process to restore services
Communicate with patients, caregivers & health plans to ensure that the process is completed
Consistently reach out to patients to provide updates and ensure that they are aware of the status of the process
Work cross-functionally with Intake, Care Teams, and all other necessary departments to ensure that patients/caregivers are engaged and getting the most value out of our services
Meet daily, weekly & monthly metrics & call requirements to ensure patients can resume services
Assist patients with troubleshooting & resolving any Medicaid related issues.
Educate patients & caregivers about the onboarding process
Work with health plans to obtain authorizations & ensure all necessary paperwork is on file & up to date
Provides necessary documentation and requirements with Pennsylvania's State Department of Health, patients' insurance and the Patient’s Caregivers to ensure services are authorized in a quick and efficient turn-around time to get them on Care
Work with other medical providers to ensure all documentation for potential patients and caregivers is in compliance
Ideal Candidate Will Possess:
Experience in managing a high volume of inbound and outbound calls
A passion for providing a high level of customer service, including the ability to show empathy, active listening and patience
Ability to articulate case statuses through detailed notes on salesforce
Computer proficiency required; strong typing skills and ability to leverage technology and resolve customer issues
Previous experience in a Customer Service environment.
High-volume inbound call center or contact center environment (at least 2 years).
Experience with CRMs such as Salesforce
Ability to organize, set priorities and manage time effectively.
Strong verbal and written communication skills,