What are the responsibilities and job description for the Member Support Specialist position at Physician Health Partners, LLC?
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Job Description:
The Member Support Specialist is responsible for connecting members and providers with existing health services to effectively navigate and maximize their use of the health system.
Essential Functions:
- Liaises between Health First Colorado members, health systems, medical providers and the CCHA Member Support Services call center in order to navigate the medical home system of care
- Provides customer service for member inquiries, to include answering eligibility and enrollment questions, administering health needs assessments, identifying barriers and presenting solutions, and triaging patients to a higher level of care coordination
- Provides customer service for physical and behavioral health provider inquiries, to include answering questions and connecting providers with available resources across the health system
- Triages incoming care coordination referrals by assessing level of urgency, reviewing and documenting needs
- Meets required inbound and outbound call statistics and documentation requirements
- Develops strong telephonic relationships with members to include educating members on proper use of the health care system, providing and/or arranging appropriate referrals to medical and non-medical services, and completing timely telephonic follow-up
- Participates in team meetings
- Maintains confidentiality and ensures compliance with HIPAA regulations
- Other duties as assigned
Knowledge, Skills and Abilities:
- Excellent verbal and written communication skills
- Great customer service skills
- Teamwork skills
- Independent problem-solving skills
- Self-motivated and self-managed
- Good computer and research skills
- Working knowledge of social determinates of health
- Proficient in Microsoft Office Suite
Qualifications:
- High School Diploma or GED
- 1-3 years’ experience in customer service
- Previous experience working in a health care setting (preferred)
- Bilingual; fluent in English and Spanish (preferred)
- Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures
Salary Range:
$17.45- $23.27
Salary : $17 - $23