Care Coordinator (Non-Clinical)

  • 16945 Northchase Dr, Houston, TX 77060, USA
  • Employees can work remotely
  • Full-time

Company Description

HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.

HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.

Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.

WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.

Job Description

NT 24 Care Coordinator (CC) – Non-Clinical program is an extension of the Nurse Triage program. The CC allows the nurse to focus on the clinical part of the call, while the CC is responsible for:

o   First Notice of Loss –Calls where IW reported incidents without injury or IW had injury but already sought treatment prior to calling the NT24 line for documentation purposes. Also applies when IW called the NT24 line but is unable to finish the call (call got disconnected or IW in a hurry) or if someone other than the IW called to report the injury.

o   Member Service calls – questions about Provider location, request for HAC/MAC (Health Access Card/Medical Access Card), etc.

o   Completing Triage calls (Nurse does the clinical part of the call) – after each Nurse completes the Triage portion of the call, the call will then be warm transferred to a Care Coordinators who will complete the IW’s demographics, identify work location code/address, answer client specific custom questions, make provider referral based on nurses recommendation and client-specific direction of care.

o   Understanding and complying with state direction of care laws (Panel States, Soft Channeling, No Soft Channeling, Full Direction of Care) when making provider referrals. 

o   Collect a recorded injury statement – a CC will call the recording line and follow a script that contains a series of questions for the IW to answer.  They will not document the injury statement at this point only the recording number that is generated by the IVR after.

o   Documentation of client deliverables – based on specific client instructions. For example, Authorization to Treat forms or other client specific forms.

o   Complete and send paperwork – CC’s send the Point of Injury Report, Medical Access Card and may also send a text message to the IW based on client instructions.

Qualifications

NT24 CC Non-Clinical Qualifications:

o   1+ year of Call Center experience

o   Must be trainable on Medical terms

o   Good communication skills

o   Good computer skills

o   Detail oriented and organized

o   Bachelor’s degree preferred or equivalent experience with HS Diploma/GED

Additional Information

All your information will be kept confidential according to EEO guidelines.

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