Job Description

POSITION SUMMARY

INBOUND ADVOCATES SUPPORT THE COMMUNICATION BETWEEN OUR MEDRISK NETWORK PROVIDERS AND THE REFERRING WORKERS COMPENSATION ADJUSTERS/NURSE CASE MANAGERS. ACTING AS LIAISON, AN INBOUND ADVOCATE TRACKS PATIENT PROGRESS FROM THE INITIAL EVALUATION TO DISCHARGE BY OBTAINING RELEVANT CASE INFORMATION FROM PROVIDERS, MAINTAINING THE INTEGRITY OF THE CASE FILE AND RELATED DOCUMENTS, AND COMMUNICATING PROFESSIONALLY AND EFFECTIVELY WITH THE REFERRING CUSTOMER. INBOUND ADVOCATES HELP STRENGTHEN MEDRISK’S REFERRAL PROCESS ENSURING EFFICIENT WORKFLOW WHILE INCREASING CUSTOMER SATISFACTION.

PRIMARY DUTIES & RESPONSIBILITIES

• Triage incoming calls to provide excellent customer service to internal and external customers
  1. Manage multiple claims and monitor case status by confirming patient attendance with Network Providers, and addressing any concerns regarding compliance
  2. Properly update all case related data to MedRisk’s database
  3. Track and relay authorization to our providers as directed by the clients with confirmations to the Adjuster and Nurse Case Manager

   

• Work closely with the Outbound Customer Advocates and the Clinicians to manage utilization
• Be knowledgeable regarding the client’s unique needs and respond appropriately
• Build approachable, professional relationships with providers and referring customers.
• Compliance with HIPAA and URAC guidelines
• Maintain TAA goal (Total Agent Availability) monthly.
• Consistently meet MedRisk Customer Support Service & Quality standards (call monitoring and COID monitoring)

QUALIFICATIONS

• Minimum of 3 years of call center experience with both in-bound and out-bound calls (medium to high volume).
• Bachelor’s Degree preferred or industry experience equivalent
• Impeccable customer service skills
• Ability to multi task in a fast paced environment
• Detail oriented
• Excellent communication skills
• Knowledge of Microsoft Word and Excel
• Computer skills in Windows environment
• Time management and strong organizational skills

COMPETENCIES (CHOOSE AT LEAST 4)

• Customer Focus
• Comprehensive Computer Skills
• Listening Informing 
• Action Oriented
• Ethics and Values
• Priority Setting
• Integrity and Trust