Sr. Member Services Rep

Altegra Health; Town of Florida (NY); On-site; USD 40,000 - 60,000; Full time

Job summary

A leading health service provider is accepting applications for a full-time Advocate position based in Miami Lakes, FL. The Advocate will engage with health plan members via calls, assessing eligibility and meeting production goals. Candidates must have a High School diploma or GED with some college experience, alongside 5-8 years in a call center role. Demonstrated communication skills and detail orientation are essential. This role supports growth in the healthcare sector while providing vital services to members.

Qualifications

• 5 to 8 years of professional call center experience.
• Experience in the health care industry, with knowledge of Medicare and Medicaid.
• Ability to work under production-driven environment.

Responsibilities

• Conduct outbound and inbound telephonic contact with health plan members.
• Achieve individual growth and production goals.
• Review and assess health plan members’ eligibility for services.

Skills

Independent work

Effective communication

Marketing and selling company services

Detail-oriented

Patience and empathy

Bilingual (English/Spanish)

Education

High School diploma or GED

Associate's degree in Health Care Administrative or related field

Tools

MS Word

MS Excel

MS 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. As an Altegra Health Advocate you will have every opportunity to improve the lives of others. You become the voice of our organization to millions of individuals who are looking for services and solutions to improve their quality of life. Join our team and set your career path in the right direction!

The Advocate role is a full-time position based in our Miami Lakes, Florida call center and reports to the Supervisor of Member Engagement for Altegra Health in the Eligibility & Enrollment division. This position holds accountability for conducting outbound and inbound telephonic inside sales/intake services to pre-qualified health plan members.

Job Description

• 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

• 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 5 to 8 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 9-6pm

Additional Information

We are located in Miami Lakes, FL now but in November we are moving to Weston, FL.