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Healthcare Concierge

Job Summary

HealthTeam Advantage is looking for a detailed professional to add to our team as Healthcare Concierge. The Concierge should have relevant customer service experience, preferably with Medicare experience and specifically with Medicare Advantage programs and familiar with PPO’s and HMO’s. Must have strong oral and written communication skills, planning and problem-solving skills and be skilled in personal diplomacy. The applicant must possess a high level of motivation, professionalism and ethical conduct and place a premium on treating others with dignity and respect.

Qualifications

Required Education
High School Diploma; GED

Required Experience
Customer service, sales or account management experience
Call Center/ High call volume handling experience
Managed care or health plan operations experience
Medicare experience preferable
Thorough knowledge of CMS guidelines, process and systems

Major Work Activities
Receive all inbound calls from the member population and conduct proactive outbound calls as assigned
Address member concerns and answer questions related to claims issues, provider resources, benefits, and member enrollment/dis-enrollment and service issues
Resolution and timely response to all member problems within expected or required time frames
Management of the customer relationship to ensure retention and maintain member loyalty
Provide member education and counseling on access to services, benefits and providers
Assume ownership and responsibility for member satisfaction with HealthTeam Advantage
Perform verification calls for members that have enrolled in the HealthTeam Advantage plan as well as perform welcome calls to those members that do not require a verification call
Assist in grievance and appeals process
Ability to work before/past normal shift hours to complete any outstanding tasks for a member(s). May have to work mandatory overtime during certain time frames in the calendar year (i.e.: AEP, Quality Measure initiatives other special projects)
Maintain personal metrics to established performance levels of the team
Ability to work either the 8:00 AM-5:00 PM, 8:30 AM-5:30 PM or 11:00 AM-8:00 PM Monday through Friday outside of Annual Enrollment Period and ability to be flexible with time during the Annual Enrollment Period when healthcare Concierge service hours are 8:00 AM-8:00 PM Seven days a week

Knowledge, Skills and Abilities
Thorough knowledge of CMS guidelines, process and systems
Excellent problem solving and organizational skills
Strong interpersonal communication skills
Excellent knowledge of Microsoft Office (Excel, Word, PowerPoint)
Ability to work independently or as a team
Operate general office equipment, including but not limited to computer, phones and related devic

Time:  Full time
Salary:  Hourly
Category:  Operations

Updated: 10/19/2018 10:03:32 AM