Senior BPM Associate

Role Description
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all. We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

UST HealthProof is searching for a highly motivated Healthcare Management Coordinator to join our team. As a Healthcare Management Coordinator, you support coordination of medical services including care management intake, health screening, and provider requests to promote effective utilization of healthcare services. Promotes and supports care managers and utilization management team as required.

• Provides support services to team members by answering incoming telephone calls, taking messages, researching information, and assisting in solving problems to include assisting members with basic benefit and program information
• Completes member health screenings to identify needed services and completes member referrals in accordance to benefit plan
• Assists care managers as needed to mail member letters, contact provider offices, arrange provider appointments and transportation, and other duties as necessary
• Responsible for initial review and triage of care team tasks to include reason for admission, facility, and member program to correctly apply intervention assessment tools
• Monitors member admissions, enters discharge dates and disposition, refers to needed services in accordance to benefit plan
• Performs non-medical research pertinent to the establishment, maintenance, and closure of member cases to include the research and resolution of claims issues
• Maintains accurate and complete documentation of required information that meets quality standards
• Protects the confidentiality of the member information and adheres to the company policies regarding confidentiality. This position description identifies the responsibilities and tasks typically associated with the performance of the position
• Other relevant essential functions may be required

Qualifications

• High school diploma required
• Bachelor's degree in health care or a related field an advantage
• Minimum of one year experience in a health care related field
• Preferred setting is hospital, medical doctor's office, or health insurance company
• Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required

Skills & Competencies

• Computer literacy to include Microsoft Office products, and internal systems to include JIVA, IKA Systems, and Symphony
• Advanced technical skills for use of hardware and software with a high degree of accuracy
• Excellent oral and written communication skills for representation of clear and concise results
• Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision
• Strong time management skills
• Must possess high degree of accuracy, efficiency, and dependability
• Strong customer service skills to assist members and/or providers with understanding healthcare information and to coordinate issue resolution
• Effective written and verbal communication and feedback
• Effective organizational skills with ability to be flexible and prioritize tasks
• Knowledge of educational assessments and learning strategies
• Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling

Skills
Healthcare,Medical Management,Ms Office