Customer Service Representative II-RCSII
at Curative, Inc
MediView is looking for a Member Services Representative. Candidates will utilize their previous experience in the Medical Field/Customer Care to increase satisfaction and retention for our clients, providers and members with accurate, consistent, timely and meaningful information. This role provides support to clients, providers and members while building rapport and collaborative relationships with current and prospective clients, providers and members in accordance with compliance guidelines. This is a remote call center position.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Answering phone calls and emails, assisting and resolving Provider and Member related requests regarding but not limited to the following:
- Commercial and Government Health Plan interpretation and benefits
- Providing all aspects of member benefit information, eligibility, referrals/authorization and claim processing information with 100% accuracy
- Directing calls and emails to correct department and escalating as needed
- Building and maintaining solid client, provider and member relationships by handling questions, concerns, resolving issues/complaints with speed and professionalism while maintaining confidentiality per HIPAA guidelines.
- Documenting provider and member complaints, determines appropriate course of action, and follow-up to ensure the complaint is resolved.
- Providing Member outreach calls as needed
- Documenting all interactions and transactions with the caller in the appropriate areas.
- Assisting Members with PCP assignments and re-assignments.
- Adhering to US regulatory and Quality System requirements.
- This position assumes and performs other duties as assigned
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:
- 3-5 years related experience and/or training in a call center environment in healthcare, insurance plan areas including knowledge of basic claim processing
- Excellent attendance is critical to success in this position
- Meet Curative COVID-19 Vaccination Policy and be vaccinated or meet vaccination exemption requirements
- 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
- Internal candidates must have been in their current role for at least 6 months and have no performance or attendance actions in effect.
REQUIRED EDUCATION, LICENSES and/or CERTIFICATIONS
- High School diploma or GED equivalent
- Bilingual in English and Spanish preferred
- Administrative/Healthcare a plus but not required
Co-founded by CEO Fred Turner and powered by a team of world-leading doctors, scientists, engineers, and health industry experts, Curative responded in March 2020 to the urgent need for COVID-19 testing, ultimately developing a network of thousands of testing sites across over 40 states and three CLIA-certified, high-complexity laboratories. As a result, Curative and its managed medical entities provided over 30 million COVID-19 tests and over 2 million COVID-19 vaccines.
Curative’s patient-facing services, healthcare facilities, integrated supply chain, and labs are part of a large platform we’ve built from the ground up that has allowed us to grow quickly and more efficiently than other healthcare companies. As a result, we were one of the first companies to respond to the pandemic providing COVID-19 testing at scale across the United States.
We are now implementing a new model of comprehensive healthcare delivery focused on the whole person’s well-being: providing expanded healthcare and wellness services while also streamlining access to preventative care. We are setting out to change healthcare in the United States and fundamentally re-designing the way that patients interact with their healthcare and health insurance. By building a connected platform for managing the health of our patients, we believe that we can deliver a better healthcare experience at a lower cost and with better outcomes so that our patients can focus on getting and staying well. Our model delivers healthcare by investing in patient preventive health from the start, reducing the barriers to entry to traditionally complex care networks and eliminating the concern of unexpected medical bills. Curative will launch its first members-only healthcare offering in Austin, January 2023.
Curative does not accept unsolicited agency resumes. Please do not forward resumes to our career page, any Curative employee(s) or any Curative location. Curative is not responsible for any third-party or recruiter fees related to unsolicited resumes.