Premium Assist Specialist, Healthcare, Remote

Centauri Health Solutions, Inc; Dallas (TX); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a Premium Assist Specialist to enhance the lives of healthcare members through compassionate outreach and support. In this remote role, you will build relationships with health plan members, guiding them through eligibility requirements and advocating for government assistance programs. Your expertise in customer service and understanding of Medicare/Medicaid will be crucial as you conduct screenings and collaborate with government offices. Join a rewarding work environment that values empathy and provides competitive compensation and benefits, including paid time off and development programs.

Benefits

Paid time off

401(k) matching

Tuition reimbursement

Health plans

Volunteer opportunities

Development programs

Qualifications

• 1+ years in a call center handling inbound and outbound calls.
• Experience with Medicare/Medicaid eligibility screening is a plus.

Responsibilities

• Make outbound and receive inbound calls providing eligibility information.
• Conduct telephonic outreach for Medicaid applications and recertifications.
• Interview patients to gather information for eligibility determination.

Skills

Bilingual in Spanish and English

Customer service

Medicare/Medicaid knowledge

Call center experience

Empathy

Attention to detail

Decision-making skills

Communication skills

Education

High school diploma or equivalent

Tools

MS Office (Outlook, Word, Excel, Teams)

Job description

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Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial, and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions address complex problems such as uncompensated care within health systems, appropriate, risk-adjusted revenue for specialized sub-populations, and improving access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri employs 1700 associates nationwide. The company has been listed on Inc. 5000 since 2019 and on the 2020 Deloitte Technology Fast 500. For more information, visit www.centaurihs.com.

Role Summary

Premium Assist Specialists build relationships with health plan members and patients interested in Centauri's services, helping determine eligibility for benefits. They interpret and clarify information such as eligibility requirements and application details, and refer patients/members to other agencies as needed. These specialists advocate for Medicare beneficiaries applying for or requalifying for government assistance programs, building trusting relationships and providing high-quality customer service.

Role Responsibilities

• Make outbound and receive inbound calls providing detailed eligibility information and conducting screenings.
• Conduct telephonic outreach for members needing to apply or recertify for Medicaid programs, including Medicare Savings Programs.
• Collaborate with government offices to complete applications and recertifications accurately.
• Secure documentation for Medicaid/MSP renewals as needed.
• Interview patients/members via phone to gather personal and financial information for eligibility determination.
• Interpret and explain eligibility requirements and application details.
• Verify and record personal and financial data for accuracy and completeness.
• Use computer systems to complete eligibility screenings and manage accounts.
• Refer patients/members to other agencies for assistance when appropriate.
• Monitor actions to ensure goals are met.
• Adhere to information security policies, ensuring data confidentiality and completing annual security training.

Role Requirements

• Bilingual in Spanish and English preferred, with full fluency in reading, writing, and speaking.
• Experience with Medicare/Medicaid and screening for Medicaid eligibility is a strong plus.
• At least 1 year in a call center environment handling inbound and outbound calls.
• Experience working with call queues for 1+ years.
• Minimum of 2 years customer service experience.
• Empathy and a desire to help others.
• Strong decision-making skills.
• Ability to work independently in a private, quiet environment.
• Attention to detail and follow-through skills.
• Experience in healthcare, government benefits, or related agencies is a plus.
• Case management experience is a plus.
• Proficiency in MS Office (Outlook, Word, Excel, Teams).
• Excellent communication and customer service skills.
• Ability to track, monitor, and retrieve call information.

We offer a rewarding work environment with competitive compensation, benefits including paid time off, 401(k) matching, tuition reimbursement, health plans, volunteer opportunities, and development programs. This position is bonus eligible.

Note: The company requires vaccination for certain in-person and hybrid roles, with accommodations available as required by law.

Other Details

• Job Function: Medium Risk
• Pay Type: Hourly
• Min Rate: $18.00
• Max Rate: $20.00

Apply now to join our team.