Member Support Specialist

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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