Member Services Coordinator

Curative - Austin, TX

Full-time

Remote - Austin, TX

Personal and Laundry Services

About the position

Curative is seeking a dedicated Member Services Coordinator to join our team and help us redefine healthcare options in a post-pandemic world. This role is pivotal in providing our health plan members, patients, and providers with accurate, consistent, and timely information. As a Member Services Coordinator, you will leverage your experience in the medical field and customer care to enhance member satisfaction and retention. You will be responsible for building rapport and collaborative relationships with current and prospective members while adhering to compliance guidelines. This position is remote and offers multiple shift options within a 24/7 call center environment, allowing for flexibility in your work schedule. In this role, you will handle a high volume of phone calls and emails, assisting members with various requests related to their health plans. Your responsibilities will include interpreting PPO insurance plans, managing member information with precision, and providing support for enrollment, claims, and referrals. You will be expected to maintain confidentiality in accordance with HIPAA guidelines while resolving member issues and complaints with professionalism and speed. Your ability to adapt to changing processes and policies will be crucial, as will your organizational skills to recall information quickly. You will document all interactions with members, ensuring that complaints are addressed and resolved effectively. Additionally, you will conduct outreach calls to members and providers for follow-ups and issue resolution. This position requires a commitment to adhering to US regulatory and quality system requirements, and you may be assigned other duties as needed. Your success in this role will be measured by your attendance, communication skills, and ability to work collaboratively in a fast-paced environment.

Responsibilities

• Answer high volume phone calls and emails, assisting and resolving Member related requests.
• Build and maintain solid member relationships by handling questions, concerns, and resolving issues/complaints with speed and professionalism while maintaining confidentiality per HIPAA guidelines.
• Interpret PPO Insurance plans and benefits for members.
• Manage and update database Member information with 100% accuracy.
• Assist with enrollment, claims, benefit interpretation, EOB's, provider selection, and referrals/authorizations for medical services and prescriptions.
• Adapt to changing processes and policies requiring excellent organizational skills for immediate recall of information.
• Handle calls and emails for all inquiries, providing a one-stop shop for support and issue resolution.
• Document provider and member complaints, determine appropriate course of action, and follow up to ensure resolution.
• Provide Member/Provider outreach calls for issue resolution and follow-ups.
• Document all interactions and transactions with the member in the appropriate areas.
• Assist Members with Provider assignments and re-assignments.
• Work adhering to US regulatory and Quality System requirements.
• Perform other duties as assigned.

Requirements

• Excellent attendance is critical to success in this position.
• High volume Call Center phone, email, and text messaging experience.
• Previous healthcare/Insurance experience preferred.
• Excellent computer and phone skills, attention to detail, process and policy adherence.
• Excellent verbal and written communication skills.
• Strong interpersonal skills and active listening skills to accurately respond to inquiries and requests.
• Exceptional organizational skills, with a strong retention of policy and process.
• Intermediate skills in Google and Microsoft Office Suite of products are a must.
• Experience with internal communication systems such as Slack, Microsoft Teams, etc.
• Internal candidates must have been in their current role for at least 6 months with no performance or attendance actions in effect.

Nice-to-haves

• Administrative/Healthcare certification is a plus but not required.

Benefits

• Remote work flexibility with a stipend for internet access.
• Office equipment provided including PC, monitor, keyboard, mouse, and headset.