As an ER Care Navigator, you are:
Responsible for ensuring efficient utilization of emergency room (ER) resources by collaborating with hospital ER staff to assess case urgency
Managing LOA issuance and redirection when appropriate
Addressing inquiries and concerns related to ER services
Delivering clear explanations of benefits to members
Supporting steerage and primary care network (PCN) initiatives to enhance healthcare efficiency and member experience.
Professional Qualification:
at least 5 years experience in customer service role
Preferred industry: Healthcare, Insurance, Pharmaceuticals...