Evry Health

Bilingual Care Coordinator, RN – Spanish

Evry Health

full-time

Posted on:

Location Type: Remote

Location: Texas • United States

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About the role

  • Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
  • Use negotiation and motivational interviewing techniques to increase engagement.
  • Pro-active and reactive support for members, including outbound phone/email/text outreach.
  • Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.
  • Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins, efficiently answering and documenting member/provider calls.
  • Accurately track and document work on a variety of internal software tools and platforms.
  • Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers.
  • Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
  • Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals.
  • Ability to interact with external facility or providers as needed to gather clinical information to support the medical necessity review process and plan of care.

Requirements

  • You have 1-2 years of experience working at a health plan, preferably with a commercial population.
  • You have 3-5 years of nursing experience in a clinical setting assisting with direct patient care, such as a hospital or ambulatory setting.
  • **Must have Spanish fluency (conversational).**
  • **Must have a current, unrestricted Texas nursing license or Compact License. __Please include your license number(s) and the corresponding state(s) in your resume.__**
  • Diploma from an accredited school/college of nursing required.
  • You have working knowledge of medical and insurance industry terminology including basic understanding of health plan benefits, CPT/ICD10, authorizations, and digital health programs.
  • You have an area of interest or experience within cardiology/pulmonology, women’s health, orthopedic surgery/physical medicine, primary care/pediatrics, and oncology.
  • You have experience outreaching and educating members telephonically.
  • You have an innovative and entrepreneurial spirit with a passion to contribute to a much-needed change in our health care system.
  • **Bonus: **Familiarity with Salesforce/Healthcloud/CareIQ.
  • **Bonus:** Experience working in a call center.
Benefits
  • Competitive salary
  • Comprehensive health, dental, and vision insurance as well as life and disability
  • Retirement savings plan with company match
  • Generous time off/vacation
  • Professional development opportunities
  • Flexible and remote work environment
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
nursingcodingmedical recordsdocumentationpre-certificationreimbursementclaim denialsCPTICD10health plan benefits
Soft Skills
active listeningnegotiationmotivational interviewingcommunicationtactfulnesscourtesyprofessionalismteam participationsense of urgencyaccountability
Certifications
Texas nursing licenseCompact Licensediploma from accredited nursing school