Member Services Coordinator Full Time NEW

Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. Curative is looking for a Member Services Coordinator who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in the medical field/Customer Care by increasing satisfaction and retention by providing Curative health plan Members, patients, and providers with accurate, consistent, timely and meaningful information. They will provide support to Members’ while building rapport and collaborative relationships with current and prospective Members in accordance with compliance guidelines. This is a remote position with multiple shift options in a 24/7 call center.

• Answering high volume phone calls and emails, assisting and resolving Member related requests regarding but
  not limited to the following:
• Building and maintaining solid member relationships by handling questions, concerns, resolving
  issues/complaints with speed and professionalism while maintaining confidentiality per HIPAA guidelines
  in a fast paced inbound and outbound phone, email, and text message call center environment.
• PPO Insurance plan interpretation and benefits
• Managing and updating database Member information with 100% accuracy
• Enrollment, claims, benefit interpretation, EOB’s, provider selection, and referrals/authorizations for
  medical services and prescriptions.
• Flexibility with changing process and policies requiring excellent organizational skills for immediate
  recall of information
• Handling calls and emails for all inquiries, we are a one stop shop for support and issue resolution
•  Documents provider and member complaints, determines appropriate course of action, and
  follows-up to ensure the complaint is resolved.
• Provides Member/Provider outreach calls for issue resolution and follow ups
• Documents all interactions and transactions with the member in the appropriate areas.
• Assists Members with Provider assignments and re-assignments.
• Work adhering to US regulatory and Quality System requirements.
• This position assumes and performs other duties as assigned.

Shift flexibility required. Shift availability based on staffing needs, no guaranteed shifts

• Available shifts options are:
  ○ Pre 6am – 2:30 cst
  ○ AM 8am – 4:30 cst
  ○ Mid Shift 10am – 6:30 cst
  ○ PM shift 3:30-midnight cst
• Available Days of the week options are:
  ○ Days of the week: Sunday – Thursday
  ○ Days of the week: Tuesday – Saturday
  ○ Days of the week: Friday – Monday

To perform this job successfully, an individual must be able to perform each essential duty with excellence. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Excellent attendance is critical to success in this position
• High volume Call Center phone, email, and text messaging experience
• Previous healthcare/Insurance experience preferred
• Excellent computer and phone skills, attention to detail, process and policy adherence
• Excellent verbal and written communication skills.
• Strong interpersonal skills.
• Active listening skills to accurately respond to inquiries and requests.
• Exceptional organizational skills, retention of policy and process a must
• Intermediate skills minimum in google and microsoft office suite of products a must
• Experience with internal communication systems such as Slack, Microsoft Team, etc…
•  Internal candidates must have been in their current role for at least 6 months and have no performance or
  attendance actions in effect.

• Only candidates meeting experience requirements will be considered
• One year minimum related experience in a high volume phone, email, text messaging call center
  environment
•  Call center experience in healthcare, medical device, and/or biotech industries preferred

CERTIFICATES, LICENSES, REGISTRATIONS – Administrative/Healthcare a plus but not required

• Remote position
• Must have password protected, stable high speed internet access – stipend will be provided
• Must have a quiet place, with no distractions to perform duties for work from home
• Work location MUST be secure and private to maintain HIPAA compliance for work from home
• Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
• While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or
  feel; talk; and hear.
•  The employee is frequently required to reach with hands and arms.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral
  vision, depth perception and ability to adjust focus.
• We also request, with the exception of emergencies, that you do not request any time off within the first
  120 days of employment. Any request within the first 120 days if approved will be unpaid
• For this position the percentage of expected Travel is:0% of the time

• You will attend a 4-5 week minimum remote training program.
• Attendance is mandatory for the full training program
•  Training will be Monday through Friday 8:30am – 5pm PST
• You will be required to take regular open book competency and retention exams intermittently during all
  weeks of training. Passing grades are 90% or above.
• We also request, with the exception of emergencies, that you do not request any time off within the first
  120 days of employment. Any request within the first 120 days, if approved, will be unpaid

Tagged as: Client Service, Customer Help, Customer Service, Support Specialist

Source ⇲