CareMore Patient Relations Representative-1

CareMore Health Management Services, LLC; Fullerton (CA); On-site; USD 41,000 - 61,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Patient Relations Representative to advocate for patients, navigate insurance benefits, and coordinate care across clinical and operational teams in a busy California environment.

You will educate patients on Medicare/Medicaid options, assist with applications, and resolve issues related to appointments, referrals, and billing while maintaining confidentiality and promoting high-quality service.

Qualifications

• High School Diploma or GED required; BA/BS preferred.
• 3+ years in healthcare operations, patient relations, or care coordination.
• Experience with Medicare/Medicaid populations preferred.
• Strong communication, interpersonal, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced setting.
• Proficiency in MS Office and healthcare systems.
• Public speaking/presentation skills; bilingual Spanish a plus.
• CA health insurance license is a plus.

Responsibilities

• Serve as primary contact for insurance, benefits, and access-to-care questions.
• Assist patients in understanding Medicare, Medicaid, and coverage options.
• Resolve concerns related to appointments, referrals, and billing.
• Advocate for patients to address barriers to access and adherence.
• Educate on public assistance programs and help with applications.
• Support onboarding and orientation to CareMore services.
• Maintain patient records with HIPAA confidentiality.

Skills

Communication

Interpersonal skills

Problem-solving

Public speaking

Spanish (Bilingual)

MS Office

Education

High School Diploma or GED

BA/BS in related field

Tools

Healthcare IT systems

Electronic Health Records (EHR)

Job description

Job Description SummaryThe Patient Relations Representative serves as a trusted advocate and resource for CareMore patients, helping them navigate healthcare services, insurance coverage, and access to care. This role is responsible for delivering an exceptional patient experience by supporting patient engagement, resolving barriers to care, and collaborating closely with clinical and operational teams to ensure patients receive coordinated, high-quality service throughout their healthcare journey.The Patient Relations Rep acts as a liaison between patients, providers, health plans, and community resources while supporting operational initiatives that improve patient satisfaction, retention, and overall care outcomes.How will you make an impact & RequirementsKey ResponsibilitiesBenefit NavigationServe as a primary point of contact for patients regarding insurance, benefits, and access-to-care questionsAssist patients in understanding Medicare, Medicaid, and health plan benefits, eligibility, and coverage optionsHelp resolve patient concerns related to appointments, referrals, billing, and care coordinationAdvocate for patients by identifying and addressing barriers to healthcare access and treatment adherenceEducate patients on available public assistance and healthcare support programsAssist patients with applications and documentation for eligible programs and servicesPatient ExperienceSupport patient onboarding and orientation to CareMore services and programsBuild strong relationships with patients and caregivers to foster trust and satisfactionPromote preventative care and encourage participation in health management programsServe as a resource for insurance and benefit-related questionsParticipate in team meetings, case reviews, and patient experience initiativesSupport organizational goals related to patient satisfaction, retention, and quality outcomesOperational & Administrative SupportPartner with clinic leadership and interdisciplinary teams to improve patient workflows and service deliverySupport scheduling coordination, documentation, reporting, and operational processes as neededMaintain accurate patient records and ensure confidentiality in compliance with HIPAA standardsParticipate in quality improvement initiatives focused on patient experience and operational excellenceCommunity EngagementPartner with SHIP/HICAP to educate SHIP on CareMore resources and understand available to our patients/Medicare beneficiariesIdentify key community organizations who can contribute to the overall wellbeing of our membershipParticipate in community outreach to support organizational net growthQualificationsRequired QualificationsHigh School Diploma or GED3+ years of experience in healthcare operations, patient relations, customer service, or care coordinationExperience working with Medicare, Medicaid, or managed care populations preferredStrong communication, interpersonal, and problem-solving skillsAbility to manage multiple priorities in a fast-paced healthcare environmentProficiency in Microsoft Office Suite and healthcare systems/platformsComfortable with public speaking, possess effective presentation skillsPreferred QualificationsBA/BS in a related FieldBilingual skills preferred (Spanish)Experience in patient advocacy, community outreach, or health plan operationsKnowledge of healthcare compliance and patient privacy regulationsCA health insurance licenseCore CompetenciesPatient-centered serviceRelationship building and communicationOrganizational and operational excellenceCollaboration and teamworkProblem-solving and conflict resolutionAdaptability and initiativeConfidentiality and professionalismCompensation Range:$29.04to$43.56The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.