Medicare Advantage Provider Call Center Support Specialist - Remote Customer Service and Healthcare Operations
Join a Purpose-Driven Organization and Empower Your Career Growth
At Health Care Service Corporation (HCSC), we're dedicated to making a positive impact on the lives of our members and the communities we serve. As a leading health insurance company, we're committed to providing exceptional customer service, innovative healthcare solutions, and a supportive work environment that fosters growth and development. Our employees are the cornerstone of our business, and we're excited to welcome a new team member to our Medicare Advantage Provider Call Center Support team.
About the Role
We're seeking a highly skilled and compassionate Medicare Advantage Provider Call Center Support Specialist to join our remote team. As a key member of our customer service operations, you'll play a critical role in supporting administrative care management duties, including member and provider outreach, healthcare initiatives, and educational campaigns. If you're passionate about delivering exceptional customer service, have a strong understanding of healthcare operations, and are looking for a challenging and rewarding role, we encourage you to apply.
Key Responsibilities
Handle a high volume of inbound calls from providers and members seeking pre-authorization or other determining authorization requirements
Support administrative care management duties, including member and provider outreach, healthcare initiatives, and educational campaigns
Assist in scheduling care manager and member appointments, respond to member inquiries, and perform data entry and research tasks
Manage low-risk members for health-related social needs, education, and basic member outreach screenings/inquiries
Develop written correspondence to internal and external stakeholders, including providers, members, and healthcare professionals
Collaborate with internal stakeholders to resolve member issues and provide solutions
Maintain accurate and up-to-date knowledge of healthcare operations, including CMS guidelines and medical terminology
Essential Qualifications
High school diploma or GED required; 1 year of college preferred
2 years of experience with communication systems, including fax, email, and telephone
1 year of experience with managed care systems or healthcare systems, such as hospitals, doctor offices, or community-based organizations
Experience coordinating member needs, providing assistance to members, and analyzing member needs
Basic knowledge of medical or healthcare terminology
Knowledge of clinical systems, including claims, enrollment, and documentation
PC proficiency, including Microsoft Office applications
Excellent customer service skills, with the ability to communicate effectively with members, providers, and internal stakeholders
Strong verbal and written communication skills, with the ability to develop clear and concise written correspondence
Preferred Qualifications
College courses in a medical field, human services, social work, psychology, or a related healthcare field
Call center experience preferred
Experience with CMS guidelines preferred
Experience with precertification systems, including MHK, FACETS, and/or QNXT strongly preferred
Experience with Verint and Finesse strongly preferred
Skills and Competencies
To succeed in this role, you'll need to possess excellent communication and interpersonal skills, with the ability to work effectively with members, providers, and internal stakeholders. You'll also need to be highly organized, with strong analytical and problem-solving skills, and the ability to prioritize tasks and manage multiple responsibilities. Additionally, you'll need to have a strong understanding of healthcare operations, including medical terminology and clinical systems.
Career Growth Opportunities and Learning Benefits
At HCSC, we're committed to investing in the growth and development of our employees. We offer a range of learning and development opportunities, including:
Curated development plans to foster growth and promote rewarding careers
Tuition reimbursement and education assistance programs
Training and development programs to enhance skills and knowledge
Opportunities for career advancement and professional growth
Work Environment and Company Culture
We offer a supportive and inclusive work environment that values diversity, equity, and inclusion. Our company culture is built on a foundation of respect, integrity, and compassion, and we're committed to providing a welcoming environment for all employees. As a remote team member, you'll have the flexibility to work from home and maintain a healthy work-life balance.
Compensation, Perks, and Benefits
We offer a robust total rewards package, including:
Competitive salary range: $17.75 - $27.83 per hour
Annual incentive bonus plan, subject to the terms and conditions of the plan
Health and wellness benefits, including medical, dental, and vision coverage
401(k) savings plan and pension plan
Paid time off, including vacation, sick leave, and holidays
Paid parental leave and disability insurance
Supplemental life insurance and employee assistance program
Why Join HCSC?
At HCSC, we're dedicated to making a positive impact on the lives of our members and the communities we serve. We're a purpose-driven organization that values diversity, equity, and inclusion, and we're committed to providing exceptional customer service and innovative healthcare solutions. If you're looking for a challenging and rewarding role that aligns with your values and career goals, we encourage you to apply.
How to Apply
If you're excited about this opportunity and think you'd be a great fit for our team, please submit your application, including your resume and cover letter. We can't wait to hear from you!
Apply now and join our team of dedicated and compassionate healthcare professionals!
Apply Now
At Health Care Service Corporation (HCSC), we're dedicated to making a positive impact on the lives of our members and the communities we serve. As a leading health insurance company, we're committed to providing exceptional customer service, innovative healthcare solutions, and a supportive work environment that fosters growth and development. Our employees are the cornerstone of our business, and we're excited to welcome a new team member to our Medicare Advantage Provider Call Center Support team.
About the Role
We're seeking a highly skilled and compassionate Medicare Advantage Provider Call Center Support Specialist to join our remote team. As a key member of our customer service operations, you'll play a critical role in supporting administrative care management duties, including member and provider outreach, healthcare initiatives, and educational campaigns. If you're passionate about delivering exceptional customer service, have a strong understanding of healthcare operations, and are looking for a challenging and rewarding role, we encourage you to apply.
Key Responsibilities
Handle a high volume of inbound calls from providers and members seeking pre-authorization or other determining authorization requirements
Support administrative care management duties, including member and provider outreach, healthcare initiatives, and educational campaigns
Assist in scheduling care manager and member appointments, respond to member inquiries, and perform data entry and research tasks
Manage low-risk members for health-related social needs, education, and basic member outreach screenings/inquiries
Develop written correspondence to internal and external stakeholders, including providers, members, and healthcare professionals
Collaborate with internal stakeholders to resolve member issues and provide solutions
Maintain accurate and up-to-date knowledge of healthcare operations, including CMS guidelines and medical terminology
Essential Qualifications
High school diploma or GED required; 1 year of college preferred
2 years of experience with communication systems, including fax, email, and telephone
1 year of experience with managed care systems or healthcare systems, such as hospitals, doctor offices, or community-based organizations
Experience coordinating member needs, providing assistance to members, and analyzing member needs
Basic knowledge of medical or healthcare terminology
Knowledge of clinical systems, including claims, enrollment, and documentation
PC proficiency, including Microsoft Office applications
Excellent customer service skills, with the ability to communicate effectively with members, providers, and internal stakeholders
Strong verbal and written communication skills, with the ability to develop clear and concise written correspondence
Preferred Qualifications
College courses in a medical field, human services, social work, psychology, or a related healthcare field
Call center experience preferred
Experience with CMS guidelines preferred
Experience with precertification systems, including MHK, FACETS, and/or QNXT strongly preferred
Experience with Verint and Finesse strongly preferred
Skills and Competencies
To succeed in this role, you'll need to possess excellent communication and interpersonal skills, with the ability to work effectively with members, providers, and internal stakeholders. You'll also need to be highly organized, with strong analytical and problem-solving skills, and the ability to prioritize tasks and manage multiple responsibilities. Additionally, you'll need to have a strong understanding of healthcare operations, including medical terminology and clinical systems.
Career Growth Opportunities and Learning Benefits
At HCSC, we're committed to investing in the growth and development of our employees. We offer a range of learning and development opportunities, including:
Curated development plans to foster growth and promote rewarding careers
Tuition reimbursement and education assistance programs
Training and development programs to enhance skills and knowledge
Opportunities for career advancement and professional growth
Work Environment and Company Culture
We offer a supportive and inclusive work environment that values diversity, equity, and inclusion. Our company culture is built on a foundation of respect, integrity, and compassion, and we're committed to providing a welcoming environment for all employees. As a remote team member, you'll have the flexibility to work from home and maintain a healthy work-life balance.
Compensation, Perks, and Benefits
We offer a robust total rewards package, including:
Competitive salary range: $17.75 - $27.83 per hour
Annual incentive bonus plan, subject to the terms and conditions of the plan
Health and wellness benefits, including medical, dental, and vision coverage
401(k) savings plan and pension plan
Paid time off, including vacation, sick leave, and holidays
Paid parental leave and disability insurance
Supplemental life insurance and employee assistance program
Why Join HCSC?
At HCSC, we're dedicated to making a positive impact on the lives of our members and the communities we serve. We're a purpose-driven organization that values diversity, equity, and inclusion, and we're committed to providing exceptional customer service and innovative healthcare solutions. If you're looking for a challenging and rewarding role that aligns with your values and career goals, we encourage you to apply.
How to Apply
If you're excited about this opportunity and think you'd be a great fit for our team, please submit your application, including your resume and cover letter. We can't wait to hear from you!
Apply now and join our team of dedicated and compassionate healthcare professionals!
Apply Now