Healthfirst
Remote
**Duties and Responsibilities:**
+ Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests
+ Review intake documents for pre-approved services and escalate discrepancies as needed
+ Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM.
+ Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable
+ Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances
+ Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans
+ Provide education to members and providers regarding...