Care Access Guide

Imagine360 is seeking a Care Access Guide to join the team! This position is responsible for researching all requests that could not achieve first call resolution and require further research and outreach. This work is inclusive of provider research utilizing internal and external technologies, negotiation with out of network providers, and other required tasks to coordinate medical services for our members. Position Location: 100% remote Responsibilities include but are not limited to: Coordinate with Navigation team to research provider accessibility and appointments for our members. Contact multiple provider offices and work with their staff to ensure plan acceptance and available access to scheduling care. Coordinate related internal and external logistics to streamline the member experience. IE: retrieval of medical records, email communications, miscellaneous administrative functions/tracking. Exercise good business judgement and time management skills while researching assigned cases. Ability to follow outlined call procedures and documentation templates. Ability to meet competitive outbound production goals. Accurately track and document applicable actions taken utilizing i360 proprietary software. Provide critical related data reporting as needed. Display superior conversation skills with providers and office staff, including the ability to explain who we are, and "get to yes" when discussing patient acceptance. Interact and build relationships with clinicians and service providers while leveraging our proprietary technology to streamline and simplify healthcare complexities and make it easy for our members to work with us. Participate in special projects and developmental opportunities, as available, to gain business exposure and build a rewarding career with i360! Required Experience/Education: High School Diploma or GED required, some college welcome Prior call center experience, preferably in an outbound production environment. Exposure to medical benefits is preferred Experience with inbound and outbound calling preferred Prior experience in collections, customer service, provider services or sales calls. Experience meeting weekly, monthly and annual, call count, production and quality goals. Experience strategizing and researching best practices for outbound calls. Skills and Abilities: Problem solvers and investigators who take initiative and enjoy making a difference Proficient in Microsoft Outlook, Word and Excel Strong verbal and written communication skills Highly organized, adept time management and prioritization abilities Trustworthy and accountable behavior, capable of viewing and maintaining confidential personal information (PHI) Willingness to routinely, reliably come to work on schedule and adjust shift/scheduling based on the needs of the organization (including occasional paid overtime). What can Imagine360 offer you? Multiple Health plan options Company paid employee premiums for disability and life insurance Parental Leave Policy 20 days PTO to start / 10 Paid Holidays Tuition reimbursement 401k Company contribution Company paid Short & Long term Disability plus Life Insurance Professional development initiatives / continuous learning opportunities Opportunities to participate in and support the company's diversity and inclusion initiatives Want to see our latest job opportunities? Follow us on LinkedIn Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions. Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation Apply To This Job