TeleMedik

Bilingual

• Communicates with members by phone to provide information regarding services covered by their respective health insurance plan.
• Provides guidance, support, and educational services on non-clinical matters related to different plan coverages and promotions.
• Manages incoming calls and refers them to appropriate resources based on the member’s specific needs.
• Documents and records transactions, including details of inquiries and actions taken.
• Refers unresolved customer complaints to a supervisor or designated departments for further investigation.
• Provides support in other Contact Center projects.
• Conducts outbound calls to members to gather information about services, satisfaction levels, and follow-up activities.
• Participates in training and development sessions.
• Ensures confidentiality and compliance with all applicable state and federal health call center regulations, including HIPAA and internal policies for the disposal of confidential information.

Bilingual CSR

IT Support

• The Help Desk Technician provides technical assistance to computer system users via face-to-face interventions, telephone, or remotely
• Provides onsite or remote support for computer systems including end-user computers/peripherals, servers, LAN, WAN, and WLAN
• Performs PC installation, relocation, upgrades, preventive maintenance, repair activities and user account maintenance via internal help desk system
• Analyzes daily backups to ensure system availability and continuity and manages a comprehensive tape backup system
• Performs ongoing PC management through proactive application of software patches, migrating users to new software releases, and repair or rebuild of end-user PC’s
• Interfaces with users to determine, acquire and setup suitable hardware/software requirements and troubleshoot and resolve user hardware/software issues
• Develops and maintains operational and procedural documentation
• Assesses and recommends new hardware and software purchases to IT management
• Performs quarterly user PC audits to ensure compliance with company policies
• Maintains company-wide inventory of computer hardware/software, network equipment, and end user software
• Maintains company-wide network diagram
• Provide on-call support during Help Desk out-of-office hours and escalate unresolved issues to appropriate team members
• Participate in ad hoc projects as deemed necessary by the System Administrator
• Ensure confidentiality and compliance with all state and federal regulations applicable to Health Call Centers, including HIPAA and internal policy for disposing of confidential information material
• Inventory Notify any expose of Protected Health Information to the supervisor immediately

Help Desk Technician

• Guide providers and insured members regarding medication rejections, prior authorizations, duplicate therapies, among other matters
• Receive calls from community pharmacies for medication authorization requests
• Process medication authorization requests according to the health care insurer’s authorized lists
• Consult the Pharmacist regarding medication authorization requests, if necessary
• Use computer systems according to the received calls (e.g., Facets, PICA, Caremark, WHI, etc.)
• Receive prescriptions via fax, forward them to the health care insurer, and deliver a copy to the supervisor
• Document received calls including the caller’s name, time, member contract number, drug name, and call process
• Ensure confidentiality and compliance with all applicable state and federal regulations for Health Call Centers, including HIPAA and internal policies
• Immediately notify the supervisor of any exposure to Protected Health Information
• Comply with core trainings and all procedures established by regulatory agencies and contractual requirements

Bilingual CSR

Help Desk Technician

Bilingual Pharmacy Technician