Member Services Specialist

Description

Curana Health is a provider of value-based primary care services exclusively for the senior living industry, including in nursing homes, assisted/independent living facilities, CCRC/life plan communities and affordable senior housing communities. Curana Health serves more than 1,100 senior living community partners across 30 states and participates in both the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics.

What we can offer you: 

We are passionate about using data and quality metrics to provide high quality care that prioritizes and preserves autonomy for the patients we serve. We are a value-driven organization that offer competitive pay, comprehensive benefits, flexible scheduling, and so much more. 

Be a part of something bigger 

Are you seeking an opportunity to make a meaningful difference for seniors? Join us and become part of a team of people whose mission is to improve the health, happiness and dignity of senior living residents! We are a compassionate primary and post-acute care organization serving seniors in assisted living, life plan communities, independent living, skilled nursing, and long-term care facilities across the United states. 

Position will be M-F and participate in a rotating shift schedule that includes 8am-5pm; 9am-6pm; 10am-7pm; 3pm-11pm ET; rotating weekends. 

Responsibilities

• Responds to Member/Provider questions via telephone and written correspondence regarding Medicare benefits, enrollment questions, change requests, eligibility, and claims.
• Analyzes problems and provides information/solutions.
• Utilizes internal systems to obtain and extract information, documents information, activities, and changes in the database.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive member/provider relations and coordinates with various functions within the company to ensure requests and questions are handled appropriately and in a timely manner.
• Researches and analyzes data to address operational challenges and member/provider service issues.
• Requires knowledge of health insurance benefits.
• Seeks, understands, and responds to the needs and expectations of internal and external customers.
• Create and manage documentation specific to contact center
• Other duties as assigned.

Qualifications/Requirements

The following requirements must be met for a candidate to be hired into this position:

• H.S. graduate or GED;
• Heath insurance experience required.
• Medicare experience preferred. Medicare Advantage plans experience is a bonus.
• Customer service and Call center experience preferred.
• Proficient written and oral communication skills required.
• Compliance, at all times, with CMS regulations regarding Medicare Advantage Plans
• Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team;
• Exceptional organizational skills
• Proficiency in computer skills including Microsoft Office Suite products

Education:

• High school or equivalent

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.   

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment. 

*The company is unable to provide sponsorship for a visa at this time (H1B or otherwise). 

Qualifications