Job description
Duties:
- Answers incoming calls from members, potential members, providers, and advocates.
- Handles and resolves member issues or assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc.
- Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. and assist providers in using the Interactive Voice Response (IVR), web portals, and verifying member eligibility.
- Document all calls in the system of record Performs the completion of PCP transfers. Process plan partner changes.
- Verifies eligibility for Plan Partners, Providers and Members.
- Assists Management with projects as needed; assist with new hire shadowing.
- Works with Member Relations Specialist to assist members with complex issues and coordination of care issues within Plan Partners.
- Trouble shoots and directs calls to the appropriate departments. Handles complex call center calls.
- Participate in Quality Scorecard Training and implement recommendations for improvement based on scorecard results.
- Check call center voicemail box as needed.
- Performs other duties as assigned.
REQUIRED:
- Healthcare call center experience;
- Available to work anywhere from 7am to 10pm;
- Medi-care experience.
Remote until 2024 but candidates must be local to Los Angeles County/can drive into Downtown L.A. if needed. Training may* be onsite for the first 7 weeks. (*will be determined at time of offer)
Job Types: Contract, Temporary
Pay: $20.00 - $24.00 per hour
Shift:
- Day shift
- Evening shift
Work setting:
- Remote
Education:
- High school or equivalent (Required)
Experience:
- Medicare: 3 years (Required)
- Call Center in Healthcare environment: 3 years (Required)
Work Location: Remote