Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. Curative is looking for a Member Services Coordinator who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in the medical field/Customer Care by increasing satisfaction and retention by providing Curative health plan Members, patients, and providers with accurate, consistent, timely and meaningful information. They will provide support to Members’ while building rapport and collaborative relationships with current and prospective Members in accordance with compliance guidelines. This is a remote position with multiple shift options in a 24/7 call center.
ESSENTIAL DUTIES AND RESPONSIBILITIES Answering phone calls and emails, assisting and resolving Member related requests regarding but not limited to the following:
● PPO Insurance plan interpretation and benefits
● Managing and updating database Member information with 100% accuracy
● Enrollment, claims, benefit interpretation, EOB’s, provider selection, and referrals/authorizations for medical services
● Directing calls and emails to correct department and escalating as needed
● Building and maintaining solid member relationships by handling questions, concerns, resolving issues/complaints with speed and professionalism while maintaining confidentiality per HIPAA guidelines.
● Documents provider and member complaints, determines appropriate course of action, and follows-up to ensure the complaint is resolved.
● Provides Member outreach calls as needed
● Documents all interactions and transactions with the caller in the appropriate areas.
● Assists Members with PCP assignments and re-assignments.
● Work adhering to US regulatory and Quality System requirements.
● This position assumes and performs other duties as assigned.
WORK SHIFTS AVAILABLE
● Available shifts options are: ○ AM: 8am - 4:30 CST ○ PM: 4pm - 12:30am CST
● Available Days of the week options are: ○ Days of the week: Friday - Tuesday
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
● Excellent attendance is critical to success in this position
● Meet Curative COVID-19 Vaccination Policy and be vaccinated or meet vaccination exemption requirements
● Internal candidates must have been in their current role for at least 6 months and have no performance or attendance actions in effect.
● Excellent computer and phone skills, attention to detail, process and policy adherence
● Excellent verbal and written communication skills.
● Strong interpersonal skills.
● Active listening skills to accurately respond to inquiries and requests.
● Exceptional organizational skills, retention of policy and process a must
● Intermediate skills minimum in google and microsoft office suite of products a must
EDUCATION and/or EXPERIENCE
● Associate's degree (A. A.) or equivalent from two-year college or technical school
● Or six months to one year related experience and/or training in a call center environment in healthcare, medical device, and/or biotech industries
CERTIFICATES, LICENSES, REGISTRATIONS
● Administrative/Healthcare a plus but not required
WORK ENVIRONMENT Member Services Coordinator
● Remote position
● Must have a quiet place, secure, with no distractions to perform duties for work from home
● Must have password protected, stable internet access - stipend will be provided
● Work location MUST be secure and private to maintain HIPAA compliance for work from home
● Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
● While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
● The employee is frequently required to reach with hands and arms.
● Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
● For this position the percentage of expected Travel is:0% of the time
TRAINING EXPECTATIONS
● You will attend a 3 week minimum remote training program. Attendance is mandatory for the full 3 week training program
● Training will be Monday through Friday 10am - 6:30pm CST
● You will be required to take daily competency exams and a retention exam on the Friday of both weeks of training. Passing grades are 80% or above.
● We also request, with the exception of emergencies, that you do not request any time off within the first 90 days of employment.