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Pre Service Specialist

CoxHealth · Lewisburg, TN

Customer Service/Call CenterPosted This week
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Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1672 PAS Financial Clearance Enterprise Scheduled Weekly Hours: 40 Hours: 8:00 AM - 4:30 PM Work Shift: Day Shift (United States of America) CoxHealth is a leading healthcare system serving 25 counties across southwest Missouri and northern Arkansas. The organization includes six hospitals, 5 ERs, and over 80 clinics. CoxHealth has earned the following honors for workplace excellence: • Named one of Modern Healthcare's Best Places to work five times. • Named one of America's Greatest Workplaces, Greatest Workplaces in Healthcare (2025, 2026), Greatest Workplaces for Women (2023, 2024), and Greatest Workplaces for Diversity (2024) by Newsweek and Plant-A Insights Group. • Acknowledged by Forbes as one of the Best Employers for New Grads. • Healthcare Innovation's Top Companies to Work for in Healthcare (2025). Benefits • Medical, Vision, Dental, Retirement with Employer Match and more (20+ hrs/week) • For a comprehensive list of benefits, please click here: Benefits | CoxHealth Job Description: A Pre Service Specialist works in a fast paced call center environment. They receive incoming and make outgoing phone calls while serving as a liaison between patients, payers, and other health care team members. The Pre Service Specialist II is responsible for order management as well as verifying patient demographics, insurance information, medical necessity and pre-authorization requirements. Calculates patient estimates based on the service scheduled, contracted plan and reimbursement allowances, benefits and out of pocket thresholds. The Pre-service specialist II may also assist in rescheduling patient appointments when required. May perform a preliminary Financial Assistance screening to determine eligibility for assistance programs, facilitate applications and schedule appointments with the Financial Navigation Team.Education: • Required: High School Diploma or equivalent Experience: • Preferred: 1 year pre-registration, scheduling, financial counseling or equivalent education/experience Skills: • Excellent customer service and interpersonal skills • Knowledge of medical terminology or CPT or procedure codes • Strong computer and relevant application use skills • Ability to multi-task in a fast paced environment • Ability to effectively adapt and respond to urgent needs and requests • Demonstrates initiative and self-motivation • Demonstrates understanding and consistent practice of need for privacy and confidentiality Licensure/Certification/Registration: • Preferred: CHAA or CRCR

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Community Health Worker

DaMar Staffing · Lewisburg, TN

Job Posting This is a remote position. Client Information - Local, Indiana-based nonprofit health care company, founded in 1994 specializing in providing health care services to Indiana families including Hoosier Healthwise, Healthy Indiana Plan, Indiana Care Select and Marketplace health insurance programs. Job Summary - The Community Health Worker is responsible for serving as a liaison/connector between the member, care team, and the community. Helps to bridge conversations with members and remove barriers that prevent them from accessing health and social services. Conducts telephonic and or face-to-face outreach to portfolio of members for appointment scheduling, needs assessments and care gap closure. Job Duties Work with internal care management team to facilitate care coordination, case management, resource delivery, and system navigation to hard-to-reach populations. Meets member in clinic, facility, or at home to help identify social determinants of health impacting member's health and general well-being. Collaborates with social worker and/or care manager to develop and implementation of the individualized care plan based on member's needs and preferences, reporting information to the care manager. Assist with identifying and managing barriers to achievement of care plan goals. Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination. Document activities, service plans, and results in an effective manner while strictly adhering to the policies and procedures in place. Help members in utilizing resources, including scheduling appointments, and assisting with completion of applications for programs for which they may be eligible. Build and maintain positive working relationships with the clients, work team, community partners, care managers, supervisors, and office staff. Leads in field data collection and submits report to Program Manager. Assist with evaluating program outcomes/service effectiveness through tracking participation levels, conducting participant surveys, reviewing chart records, and engaging member in regular follow-up. Perform other duties as assigned. Job Qualifications High School Diploma or General Education Diploma (GED), is required. Bachelor degree a plus. Minimum of two (2) years of experience in either volunteer or paid position working in community setting with at risk populations providing coordination of services is preferred Ability to attain Community Health Worker certification within 1 year of hire Bilingual (Spanish) a plus Previous experience servicing diverse populations in rural areas is a plus This is a mobile position, meaning that regular travel to different work locations, including homes, offices, or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or site for long periods of time. Must be able to prioritize and meet deadlines, detail oriented and exercise good judgment Above average organizational skills, good listener, team player. Must possess/maintain a valid driver's license, current automobile insurance and a driving record that meets the guidelines and requirement of the organization. Hours TBD Starting Salary $40,000 to $55,000 (based on experience); Health Insurance and Benefits offered

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$71k–$98k/yr

Care Coordinator, RN Field Based

Humana · Lewisburg, TN

Care Coordinator 2 (Field Care Manager 2) Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. This position serves members of the new Indiana Medicaid program - Indiana PathWays for Aging (PathWays). The program was designed to help more Hoosiers who choose to age at home, do so, and to achieve better access toservices, and better health and quality outcomes. You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as we have grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you are working from home, from the field, from our offices, or from somewhere in between—you will feel welcome here. We are a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected. Community is a verb here. It is up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve. Health Insurance begins on day one! 23 days of vacation with pay per year 401K program matching 100% of 6% after year one! Position Responsibilities The Care Coordinator 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. • Facilitate the development of a longitudinal and trusting relationship with each member toward improved quality, continuity, and coordination of care. • Responsible for the coordination of all the member's needed medical and non-medical services, including functional, social, and environmental services. • Works collaboratively with the Service Coordinator, Transition Coordinator, and other care team staff to address the member's identified needs • Coordinates with all Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits of members who are also eligible for Medicare. • Primary point of contact for the Interdisciplinary Care Team (ICT) and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member's needs are met. Required Qualifications • Licensed Registered Nurse (RN) in the state of Indiana without restrictions • At least one (2) years of clinical experience as a nurse in providing case management or similar health care services • Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. • Exceptional communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. • Proven ability of critical thinking, organization, written and verbal communication and problem-solving skills. • Ability to manage multiple or competing priorities in a fast-paced environment. • Ability to use a variety of electronic information applications/software programs including electronic medical records. • Live/Reside in Indiana Preferred Qualifications • Bilingual (English/Spanish) or (English/Burmese) • Prior nursing home diversion, long-term care, disease management, or case management experience • Prior management of Home and Community Based Services waivers (HCBS dual roles only) • Prior experience with Medicare & Medicaid recipients • Experience working with a geriatric population • Experience with health promotion, coaching and wellness • Knowledge of community health and social service agencies and additional community resources Additional Information Your growth is what drives Humana forward. When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we do not grow without you. This is a place where our nurses influence the C-suite. Where software engineers change lives. Where every associate can build a professional path where they learn and thrive. Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and security. Because finding new ways to put health first—for our members and patients and our associates alike—is what we do. Additional Requirements/Adherence Workstyle: Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours: Must be able to work a 40-hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs. Travel: Must be willing to commute about 70% to meet with members. On Call: Telephonic on call for an occasional night and/or weekend may be required. Work at Home Guidance: To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driver's License, Transportation, Insurance This role is a part of Humana's Driver Safety program and therefore requires and individual to have: Valid state driver's license Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits Access to a reliable vehicle Tuberculosis (TB) screening program This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance

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