EXL (NASDAQ: EXLS) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 26,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), South America, Australia and South Africa. For more information, visit www.exlservice.com.
This position is responsible for inbound & outbound calls to introduce and interest members in enrolling in Care Management Programs. The Health Care Coordinator is also responsible for providing non-clinical support and exceptional customer service to multiple clients. This position requires knowledge in multiple processes and system programs. Responsibilities include attending and understanding scheduled trainings on customer accounts as well as client and internal systems.
This role includes collaboration with HI employees and clients to ensure turnaround times are met for clinical and non-clinical determinations and or actions. Health Care Coordinators will ensure that all required data elements are captured in the clinical information management system. This includes special attention to HIPAA compliance, data quality and client satisfaction while engaged in a telephone conversation.
This is a full-time position that requires schedule flexibility to maintain customer satisfaction. Changes in schedule may include work hours and workdays according to business demands as defined by company policies and procedures.
This position could be subjected to mandatory paid overtime based on business factors that may change periodically.
Shift: Monday- Friday 12pm-8:30pm
• Makes outbound calls to targeted members to invite them to participate in the programs we service
• Receives inbound calls from targeted members inquiring about the programs we service
• Explains how to use the MCCM program/ other care management programs and its benefits to targeted members
• Addresses members’ questions and non-clinical concerns
• Builds trust, rapport with members and establishes credibility of the program
• Responsible for engaging members into active program participation, using consultative soft sales approach
• Accurately captures member communication preferences and contact information
• Quality Service Delivery
• Promotes and provides a customized set of program services and engagement options for members, based on members’ different needs and/or preferences
• Assigns members to appropriate Clinician based on member preference, member need, or coach availability
• Schedules first clinical call
• Responsible for meeting all individual and team performance metrics including, but not limited to, call quality, success, quality audit metrics and attendance
• Provides updates about new program features
• Coordinates with MCCM program / other care management programs; clinical and non-clinical staff to ensure member satisfaction
• Responsible for enrolling members into active engagement with the MCCM program / other care management programs
• Handles member questions, concerns and complaints
• Resolves complaints with first call
• Responsible for adhering to all HIPAA requirements as outlined in policies & procedures
• Maintains an in-depth understanding of the MCCM program / other care management programs, including member identification criteria, interventions available and the ability to explain this clearly to members.
• Becomes knowledgeable of all Health Plans and Health Integrated specific client information and consistently maintains that knowledge base.
• Delivers professional customer service to members, providers, and clients in accordance with all policies and procedures.
• Performs all administrative functions as required in contractual agreements with our clients.
• Accountable for creating and fostering a team environment through participation in team activities; individual morale; willingness to pitch in and to be a part of the solution.
• Handle all department voicemail box's through outlook
• Superior verbal communication skills are required in order to effectively promote program services and coordinate services with participants
• Must be able to clearly articulate program services, answer questions and provide support for members
• Demonstrated success using consultative selling to establish trust and rapport with members
• Demonstrated success in a call center environment to include multi-tasking, as well as focusing singularly on the task at hand
• Ability to handle detail-oriented work with good problem solving skills.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Strong understanding of customer needs and requirements
• Strong interpersonal skills with capacity to project warmth and empathy
• Effective listening and organizational skills
• Ability to use multiple computer applications (i.e. database, word-processing) and ACD telephone system
• Must be flexible and willing to accept changes occurring in a dynamic environment
• The ability to maintain quality, productivity and procedures, as defined by applicable policies & procedures
• Ability to follow directions with minimal supervision
• Ability to multitask; demonstrate ability to type 40 words per minute with accuracy while engaged in a telephone conversation
• Proficiencies with basic computer skills to include how to navigate and access various programs including Microsoft / Google applications
• Must be an effective communicator, both written and verbally – able to clearly articulate information to members, providers and facilities.
• May require flexibility; must be willing to accept changes occurring in a dynamic environment
• Medical Terminology Preferred
High School Diploma or GED required.
Associate’s Degree or technical school preferred or equivalent relevant work experience. Bilingual in Spanish strongly preferred.
Work Experience Requirements:
One year experience in a telemarketing role, healthcare related business experience desirable. Previous experience as a concierge or health advocate or previous experience in a clinical sales role preferred. One year experience in a call center environment is preferred.