
Healthcare Insurance • Fintech • SaaS
Vālenz® Health is a comprehensive health plan solutions provider that offers a fully integrated platform designed to simplify the complexities of healthcare for employers, payers, providers, and members. The company focuses on enhancing quality and lowering costs through data-driven insights, member navigation, provider networks, and robust claims management. By connecting various stakeholders in the healthcare ecosystem, Vālenz aims to improve health outcomes and streamline the healthcare experience for all involved.
October 18
🗣️🇪🇸 Spanish Required

Healthcare Insurance • Fintech • SaaS
Vālenz® Health is a comprehensive health plan solutions provider that offers a fully integrated platform designed to simplify the complexities of healthcare for employers, payers, providers, and members. The company focuses on enhancing quality and lowering costs through data-driven insights, member navigation, provider networks, and robust claims management. By connecting various stakeholders in the healthcare ecosystem, Vālenz aims to improve health outcomes and streamline the healthcare experience for all involved.
• Receive inbound calls, faxes, and web requests from providers and/or clients • Initiate and facilitate the authorization process in accordance with established health plan policies and procedures • Document demographic information obtained from telephonic, fax, or emailed requests within the care management system • Make outbound calls to follow up on discharge information or request updated clinical information as necessary for concurrent review • Screen inquiries to determine the services that require certification at the time of the inquiry • Obtain clinical information and forward the caller to the clinical staff for completion of the review • Provide certification based upon scripted clinical algorithms or benchmark Length of Stay • Collaborate and effectively communicate with internal and external partners • Stay up to date on Summary Plan Documents and other related resources related to service requests • Ensure applicable URAC standards, Confidentiality/HIPAA standards, and internal policies, practices, and productivity metrics are met • Performs other related duties as assigned by supervisor • Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.
• 2+ years of experience in high-volume call center or customer support environment • High attention to detail while maintaining courteous, accurate, and timely relations with our partners and members • Strong problem solving skills • Excellent communication skills, both verbal and written • GED or High School Diploma • Fluent in reading, writing, and speaking Spanish and English • A plus if you have: Medical, claims, or collection call center experience. • Medical Terminology Certification • Microsoft Office Suite experience
• Competitive benefits package with generous employer subsidies • Flexible and remote working options • 401k with generous employer match and immediate vesting • Personal and professional development opportunities • Supportive family benefits, including paid leave for new family members • Companywide philanthropic program, Valenz Communities Connection
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