Member Support Specialist

Quantum Recruiters

  • Springfield, OR
  • $20.00 per hour
  • Contract
  • Full-time
  • 28 days ago
At Quantum Recruiters, we focus intently on providing talent to leading employers throughout the Pacific Northwest. For over 80 years, our client has built a reputation based on taking great care of people by delivering insurance plans to individuals and businesses throughout the Northwest. We are currently recruiting to fill a full-time, contract Member Support Specialist position.** This is a 3-4 month contract position**Essential Responsibilities:
  • In coordination with the member’s case manager, develop and implement goals and/or plans tailored to assist members in navigating the complexities of the healthcare system.
  • Educate members on understanding and working within the parameters of their benefit structure.
  • Utilize motivational interviewing and patient-engagement techniques to support members in achieving optimal health outcomes by effectively utilizing their benefits.
  • Identify community resources and make referrals to members as appropriate.
  • Serve as liaison between members and providers/agencies.
  • Identify members for coordination and case management services through a variety of methods, including claims data and reports.
  • Screen requests to identify appropriate referrals to case management from multiple internal and external sources.
  • Work collaboratively with the case management team to help facilitate case management process. Participate in case management/care coordination meetings.
  • Ensure compliance with applicable state and federal regulations and guidelines in day-to-day activities, including maintaining HIPAA standards and confidentiality of protected health information. Ensure accurate and timely documentation.
  • Assist members with referrals, scheduling appointments and ensuring transportation to medical appointments is available.
  • Assist members with non-clinical needs for transitions and different phases of care.
  • Manage mailing lists and outgoing mailings.
Supporting Responsibilities:
  • Assist with the development of departmental procedures, reports and projects.
  • Assist care management to meet quality measures as outlined by government regulations.
  • Enter and collate data: prepare reports as assigned.
  • Participate in team, department, company, and community-related committees as requested.
  • Make presentations to small groups. Actively participates in quality improvement initiatives.
  • Meet department and company performance and attendance expectations.
  • Perform other duties as assigned.
Work Experience: A minimum of three years of experience in community services or healthcare agencies focused on coordination services required. Experience in health insurance and delivering group presentations preferred.Education, Certificates, Licenses: High school diploma or equivalent required.Knowledge: Medical terminology. Proficient in Microsoft Office, including Word, Excel, PowerPoint, Medical management software (e.g CaseTrakker Dynamo). Excellent verbal and written communication skills and is able to work independently as well as to work effectively on a team. Good working knowledge of how to access community resources and healthcare system.Job Types: Full-time, Contract, Temporary, SeasonalBenefits:
  • Work from home

Quantum Recruiters