Website Anthem
Position Summary:
The Health Program Representative I is responsible for providing initial contact between distinct Care Management programs and specific identified members. Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features.
Key Responsibilities:
- Contacts physician offices to obtain demographic information or related data as needed.
- Directs member inquiries to appropriate clinical staff.
- Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services.
- Initiates referrals and manages consults from clinicians for participants registered in Care Management.
- Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources.
- Records call details and utilize call scripts as needed based on client requirements.
- Gathers and records appropriate member information in accordance with policies and procedures via telephone.
Required Education & Experience:
- Computer/keyboarding proficiency strongly preferred.
- Previous healthcare experience preferred.
- Requires HS diploma or the equivalent and a minimum of 6 months experience in a telesales or customer service; or any combination of education and experience which would provide an equivalent background.
- Medical terminology.
- Experience with MS Office suite
- Knowledge of company products, services and benefits preferred.