Member Services Representative
Where
- Glen Mills, PA
What you'll be doing
- Triages calls regarding clinical issues or service arrangements, making referrals to care coordinators when indicated. Listens to member concerns, and resolves problems on a timely basis per interpretation of policies & procedures. Arranges for order/delivery of medical equipment, supplies, and services as requested by the community care coordinator or the primary care physician. Completes the outbound enrollment verification calls per policy and procedure. Performs initial enrollment contact with new health plan members including answer questions, reviewing the benefit package, scheduling home visits to address issues not manageable by telephone. Meets established criteria for canopy documentation requirements per policies & procedures. Assists with arranging for events/marketing tables. Identifies members to serve as ambassadors for the health plan. Maintains resident confidentiality and abides by resident rights and responsibilities. Manages daily utilization information and distributes and documents as appropriate. Complies with health plan policies and procedures and conforms to CMS requirements.
What your background should be
- Previous 4-6 years of experience in healthcare or insurance environment is required. Organizational and time management skills. Friendly with exceptional communication and listening. Excellent customer service skills. Valid driving license with good driving record.
Required Schooling / Training
- Associate of arts or related degree required.
Who is the client company
- This is an American operator and developer of retirement communities.
- If you are interested in this position, send your resume to apply@kochdavis.com
