Sr. Member Services Rep

RESPONSIBILITIES

• Interact with health plan members through outbound and inbound telephonic contact to review and assess health plan member’s eligibility for services.
• Achieve individual growth and production goals.
• Contribute to the department’s success by succeeding at departmental and quality metrics.
• Review correspondences and/or inquiries from the health plan members to determine needs and fast track highly qualified cases.
• Acknowledge, follow-up, and close out correspondence and/or inquiries as assigned.
• Stay informed with current knowledge of state and federal regulatory requirements.
• Comply with all company and department operational guidelines and policies.
• Participate in Altegra Health staff and operational development programs as assigned.
• Must have a High School diploma or GED and some college coursework. Associates degree preferred with a focus in Health Care Administrative, Business, Finance, or a related field from an accredited college or university. Verifiable experience which demonstrates the ability to perform the functions of the position.
• Must have 5 to 8 years of professional call center experience.
• Ability to work independently
• Demonstrates patience and empathy.
• Business demeanor and skills with the ability to communicate effectively (verbal, written and listening skills).
• Ability to successfully market, sell, and promote company services in an outbound call center (production driven) environment.
• Professional behavior with courteous, polite and energetic qualities.
• High commitment to accuracy, high quality work, and detail-oriented.
• Must be driven and motivated to exceed individual and team goals.
• Able to learn and adapt to changing environments, applications and software.
• Experience with the health care industry. Prefer general knowledge of Medicare, Medicaid, and Managed Care.
• Knowledge of MS Word, Excel and PowerPoint.
• Bilingual is a plus (English/Spanish).

MUST BE ABLE TO WORK M-F 9-6pm

We are located in Miami Lakes, FL now but in November we are moving to Weston, FL .