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Member Support Specialist

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High School Diploma or GED required., 1-3 years of customer service experience needed., Previous experience in a healthcare setting is preferred., Bilingual in English and Spanish is a plus..

Key responsabilities:

  • Liaise between members, providers, and the call center to navigate health services.
  • Provide customer service for member and provider inquiries, including eligibility and enrollment questions.
  • Triages incoming care coordination referrals and assesses urgency.
  • Develop strong telephonic relationships with members and educate them on the healthcare system.

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Alpine Physician Partners Scaleup https://www.alpine-physicians.com/
501 - 1000 Employees
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Job description

Are you looking to work for a company that has been recognized for over a decade as a Top Place to Work? Apply today to become a part of a company that continues to commit to putting our employees first.

Job Description:

The Member Support Specialist is responsible for connecting members and providers with existing health services to effectively navigate and maximize their use of the health system.

Essential Functions:

  • Liaises between Health First Colorado members, health systems, medical providers and the CCHA Member Support Services call center in order to navigate the medical home system of care
  • Provides customer service for member inquiries, to include answering eligibility and enrollment questions, administering health needs assessments, identifying barriers and presenting solutions, and triaging patients to a higher level of care coordination
  • Provides customer service for physical and behavioral health provider inquiries, to include answering questions and connecting providers with available resources across the health system
  • Triages incoming care coordination referrals by assessing level of urgency, reviewing and documenting needs
  • Meets required inbound and outbound call statistics and documentation requirements
  • Develops strong telephonic relationships with members to include educating members on proper use of the health care system, providing and/or arranging appropriate referrals to medical and non-medical services, and completing timely telephonic follow-up
  • Participates in team meetings
  • Maintains confidentiality and ensures compliance with HIPAA regulations
  • Other duties as assigned

Knowledge, Skills and Abilities:

  • Excellent verbal and written communication skills
  • Great customer service skills
  • Teamwork skills
  • Independent problem-solving skills
  • Self-motivated and self-managed
  • Good computer and research skills
  • Working knowledge of social determinates of health
  • Proficient in Microsoft Office Suite

Qualifications:

  • High School Diploma or GED
  • 1-3 years’ experience in customer service
  • Previous experience working in a health care setting (preferred)
  • Bilingual; fluent in English and Spanish (preferred)
  • Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures

Salary Range:

$17.45- $23.27

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Self-Motivation
  • Teamwork
  • Communication

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