Precertification Specialist


Strategic Staffing Solutions


Strategic Staffing Solutions is currently looking for a Bilingual Precertification Specialist for a contract opportunity with one of our largest clients located in Detroit, MI!

Title: Precertification Specialist

Location: Detroit, MI (Work from home)

Duration: 12+ Months

Role Type: W2 Contract Engagement

*Must be within a reasonable proximity to Detroit.

*Anticipated work hours vary between 8:00a.m. – 8:00p.m. (to include rotating Saturdays, holidays, and overtime as needed).

Required Skills and Experience:

  • Medical Terminology or medical background such as nursing assistant/tech or doctor office experience
  • Customer Service experience
  • Exceptional phone skills
  • Administrative/PC skills

Highly preferred:

  • Provide high quality, member focused servicing using knowledge of plans, products, systems, and procedures to meet or exceed member experience
  • Assist in locating primary care physicians, specialists and dentists
  • Thoroughly explain wellness care management program benefits to members
  • Work as a team member to assist nurses in researching providers, eldercare, nursing homes
  • Concisely and accurately enter documentation into Care Advance
  • Effectively engage over the phone via both inbound and outbound members that qualify for our clinical programs or those who are interested in learning more about our services
  • Refer and/or warm transfer to wellness and care management components and other client areas and vendors as needed
  • Process provider requests as needed
  • Act as member’s first trusted source for WCM programs
  • Schedule appointments between the member and coach in appropriate systems
  • Assign referrals to designated staff
  • Process requests for compliance inquiries
  • Access various WCM department mailboxes and voicemail as needed
  • Ability to function independently
  • Critical Thinking
  • Quick learner
  • Bi-Lingual/Spanish

The S3 Difference

The global mission of S3 is to build trusting relationships and deliver solutions that positively impact our customers, our consultants, and our communities.  The four pillars of our company are to:

  • Set the bar high for what a company should do
  • Create jobs
  • Offer people an opportunity to succeed and change their station in life
  • Improve the communities where we live and work through volunteering and charitable giving

As an S3 employee, you’re eligible for a full benefits package that may include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Plan
  • Vacation Package
  • Life & Disability Insurance Plans
  • Flexible Spending Accounts
  • Tuition Reimbursement

Job ID: JOB-235667
Publish Date: 22 May 2024

Tagged as: Precertification Specialist