Personify Health

Triage Specialist

Posted on

February 24, 2025

Job Type

Full-Time

Role Type

Triage

License

None Required

State License

Rhode Island

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Help & Resources

Company Description

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Job Description

As a Triage Specialist you will efficiently assess and prioritizes incoming cases, ensuring urgent matters are addressed promptly and directing non-critical issues to the appropriate resources. They act as the first point of contact, providing quick, accurate evaluations and facilitating smooth workflow across departments or teams.

Requirements

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including: Medical terminology course preferred Prior experience in customer service and/or medical background Prior insurance and/or claims background Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience Associate degree preferred in business, management, or related field You also take pride in offering the following Core Skills, Competencies, and Characteristics: Strong written and verbal communication skills Ability to work independently Highly adaptable to change Ability to make cold calls Proficient in Microsoft Excel, Word, and Outlook, UM Web, El Dorado Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment Demonstrate ability to work independently with excellent judgment Accurate data entry skills (40wpm) Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable Excellent interpersonal and communication skills Strong customer orientation

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Responsibilities

Review referrals to identify possible high dollar concerns and case management needs, upload case referrals for potential case management Create cases in a computer software program Accurate Stop Loss notification for potential high dollar claims Provide admin support to assigned nurses Monitor cases under high dollar case type; close cases in a timely manner when no further needs are identified Perform accurate data entry and maintain complete and detailed documentation of case information in the software computer systems Be able to meet productivity, quality, and turnaround time requirements on a daily, weekly, and monthly basis Ability to meet metrics monthly Regular and predictable attendance and punctuality

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