Member Services Advocate III - Health Plan Support

Altegra Health Inc; Florida; On-site; USD 40,000 - 55,000; Full time

Job summary

A healthcare services organization is seeking a full-time Member Services/Sr. Customer Service Rep for its Weston, Florida corporate center. This role involves engaging with health plan members through telephonic communication to assess their eligibility for services. Candidates should have a minimum of a High School diploma and professional call center experience, preferably in the health care sector. The position demands excellent communication skills, the ability to work independently, and a commitment to quality work.

Qualifications

• 4 - 6 years of professional call center experience is required.
• Experience in the health care industry with knowledge of Medicare, Medicaid, and Managed Care is preferred.
• Bilingual skills (English/Spanish) are a plus.

Responsibilities

• Interact with health plan members through outbound and inbound calls to assess eligibility for services.
• Achieve individual growth and production goals.
• Contribute to the success by meeting departmental and quality metrics.

Skills

Effective communication skills (verbal, written, listening)

Patience and empathy

Ability to work independently

Detail-oriented

Self-motivation

Education

High School diploma or GED

Some college coursework, Associates degree preferred

Tools

MS Word

Excel

PowerPoint

Job description

Over 20 million individuals benefit from services that Altegra Health provides. When you join our team, you stand on the foundation of a successful organization that enriches an individual's life. We place a high value on qualities such as integrity, empathy, excellence and trust.

Job Description

We offer a full-time position as an Altegra Member Services/Sr. Customer Service Rep at our Weston, Florida corporate center. The position reports to the Advocate Supervisor in the Member Services division. Our Sr. Customer Service Reps are professionals who interact with health plan members through outbound and inbound telephonic contact to complete various intake services.

RESPONSIBILITIES:
• Interact with health plan members through outbound and inbound telephonic contact to review and assess health plan member’s eligibility for services.
• Achieve individual growth and production goals.
• Contribute to the department’s success by succeeding at departmental and quality metrics.
• Review correspondences and/or inquiries from the health plan members to determine needs and fast track highly qualified cases.
• Acknowledge, follow-up, and close out correspondence and/or inquiries as assigned.
• Stay informed with current knowledge of state and federal regulatory requirements.
• Comply with all company and department operational guidelines and policies.
• Participate in Altegra Health staff and operational development programs as assigned.

Qualifications

QUALIFICATIONS:
• Must have a High School diploma or GED and some college coursework. Associates degree preferred with a focus in Health Care Administrative, Business, Finance, or a related field from an accredited college or university. Verifiable experience which demonstrates the ability to perform the functions of the position.
• Must have 4 - 6 years of professional call center experience.
• Ability to work independently.
• Demonstrates patience and empathy.
• Business demeanor and skills with the ability to communicate effectively (verbal, written and listening skills).
• Ability to successfully market, sell, and promote company services in an outbound call center (production driven) environment.
• Professional behavior with courteous, polite and energetic qualities.
• High commitment to accuracy, high quality work, and detail-oriented.
• Must be driven and motivated to exceed individual and team goals.
• Able to learn and adapt to changing environments, applications and software.
• Experience with the health care industry. Prefer general knowledge of Medicare, Medicaid, and Managed Care.
• Knowledge of MS Word, Excel and PowerPoint.
• Bilingual is a plus (English/Spanish).

MUST BE ABLE TO WORK M-F 11am - 8pm or 2pm - 11pm.

Additional Information

All your information will be kept confidential according to EEO guidelines.

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