Healthfirst

Customer Support

• Conduct outreaches for newly enrolled members to review current and approved services, DME and additional requests
• Review intake documents for pre-approved services and escalate discrepancies as needed
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify issues or clinical risks for escalation
• Initiate and finalize authorizations in Trucare for preapproved services and DMEs; update and discontinue authorizations when applicable
• Handle and accurately document calls with members regarding benefits, appointments, assessments, service issues, and grievances
• Handle and accurately document calls with providers regarding authorizations, referrals, visits, tests, and faxed care plans
• Provide education to members and providers about approval requirements for service requests
• Manage a large caseload while communicating member issues and monitoring screenings to improve quality and cost outcomes
• Communicate with inter/intra-departments to reconcile onboarding issues
• Handle member mailings, fax clinical requests and approved service plans, and other non-clinical support tasks

Bilingual Support Specialist – English, Mandarin or Cantonese