The Customer Solutions Advocate manages the referral process by coordinating therapy services between injured workers, providers, and stakeholders. They are responsible for accurate data entry, maintaining compliance with regulations, and providing exceptional customer support through various communication channels.
Manage single referral cases from intake through scheduling by conducting rapid provider outreach, negotiating rates, resolving placement barriers, and keeping stakeholders updated. Develop provider relationships and network coverage, support conversion of frequently used providers into contracted partners, and maintain accurate records while meeting service levels and performance targets.
The Clinical Care Advocate manages the reauthorization process for medical visits by coordinating with providers and stakeholders to ensure continuous patient care. They maintain accurate documentation, track claims, and provide transparent communication regarding case status.
