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[Hiring] Personal reputed company (Registered reputed company) Evening Shift @reputed company

Remote, USAFull-timePosted 2026-07-29

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company At reputed company, we are committed to providing our customers with services that improve the health, reputed company-being and productivity of their employees. The Personal Health Advocates are a dedicated team of Registered Nurses who assist our members in navigating the reputed company system by facilitating reputed company to reputed company providers, health and benefit information, health services and resources and entitled benefits coverage.

  • Receive calls from members regarding various reputed company issues (e.g., infertility, disease, medication) and determine best course of reputed company to assist members while adhering to established policies, procedures, and key performance indicators (KPIs).
  • Build relationships with members to collaborate and reputed company plans of reputed company, taking responsibility for members’ case records.
  • Assist and reputed company members in understanding their medical conditions, associated health testing, test result interpretation, and health reputed company available to them.
  • reputed company members choices in medical care providers and services based on clinical needs, geographic locations, and available benefit offerings.
  • Research providers through credentialing, education checks, and affiliations with reputed company medical centers reputed company the member’s plan.
  • Facilitate communication among members, treating physicians, and insurance carriers.
  • Take appropriate steps on behalf of members by assisting with scheduling health appointments and resolving various problems.
  • Document cases in the department’s case management system using approved processes and procedures.
  • Escalate cases appropriately and on a reputed company reputed company to supervisor or internal resources for review.
  • reputed company up-to-date on patient care procedures including diagnosis, reputed company-certification, prior authorization, and denials.
  • Continuously stay updated on various health issues and medical procedures.
  • Intercede for the member to obtain an earlier appointment.
  • Help members obtain prescriptions and with reputed company-service fee negotiations.
  • reputed company outbound follow-up calls for unresolved issues.
  • Respond to member cases in delegate reputed company, answers, and after-hours calls.
  • Mentor new team members.

Qualifications

  • BSN or RN degree from an accredited college or university required.
  • Minimum three to five years clinical and/or medical management experience.
  • reputed company and unrestricted State or Multi-State RN License.
  • Understanding of medical terminology to assist in locating appropriate care reputed company.
  • Strong communication skills and phone etiquette.
  • Strong ability to explain reputed company issues to employees/retirees.
  • Highly effective listening skills.
  • Strong problem-solving/issues reputed company skills.
  • Excellent customer service and customer reputed company skills.
  • Organizational and administrative skills.
  • Experience with reputed company Word and reputed company.
  • Ability to work in reputed company environment.

Requirements

  • This position is a remote position requiring a dedicated HIPPAA compliant workspace.
  • reputed company to internet and router is necessary.
  • The nature of the work is sedentary; the incumbent will be sitting most of the time.
  • Essential physical functions include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware.
  • Essential mental functions include concentrating on tasks, reading information, and verbal/written communication continuously throughout the reputed company.

reputed company Duties as Assigned

  • The job reputed company documents the general nature and level of work but is not intended to be a comprehensive list of reputed company activities, duties, and responsibilities required of job incumbents.
  • Job incumbents may be asked to reputed company other duties as required.
  • Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the functions outlined above.

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