Member Services Inbound Specialist

Summary

Join Homeward in revolutionizing healthcare access for rural communities! As a Member Services Specialist, you'll be the primary point of contact for prospective and current members, providing empathetic support and navigating them through the healthcare system. Based in a centralized operations team, you will collaborate with in-market teams and other departments to ensure members receive the care they need. This role requires strong communication skills, detailed knowledge of Medicare, and experience in a primary care setting. Homeward offers a competitive salary, comprehensive benefits, and a flexible work arrangement.

Requirements

• 1+ years of support experience in a Primary Care setting
• In-depth knowledge of Medicare, Medicare Advantage, and Medicare Dual Special Needs Plans
• Experience using professional judgment to escalate potentially emergent clinical phone calls to the Clinical team
• Highly detail-oriented: you routinely catch the little things that others miss or overlook
• Exceptional communication skills to support work with different groups of stakeholders and communicate process and progress to the organization
• Empathetic, member-first attitude and approach as you help our members and potential members navigate healthcare

Responsibilities

• Provide non-clinical telephone support to Members and potential Members
• Schedule appointments for Members
• Register demographic and insurance information in the electronic health record platform
• Run insurance verification with Member’s insurance company for all visits
• Process prior authorizations
• Receive, send, and manage Member referrals
• File Member documents ensuring complete and accurate information
• Process payments and copays. Maintain detailed and accurate records of financial transactions, and perform end-of-day processes and reports
• Field and transfer clinical inquiries to the Clinical team with appropriate detail and judgment
• Maintain basic knowledge of remote patient monitoring device functions and troubleshooting
• Identify and execute additional projects and processes to create efficiencies and scale for the Member Services department
• Maintain department SLAs and standards of service
• Clearly document all patient-related communication and activity

Preferred Qualifications

• Proficiency with the Athena EHR platform
• Working knowledge of ZenDesk
• Experience working in a remote environment and with virtual care offerings
• Strong familiarity with referrals and prior authorizations
• College degree
• In-depth knowledge of Medicaid, Affordable Care Act, or other government health plans

Benefits

• Competitive salary, equity grant, Unlimited PTO
• Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
• Company-sponsored 401k plan
• Flexible working arrangement, with offices in the Bay Area, Chicago and Austin
• Salary Range is $45,000 - $60,000 annually