Hybrid Member Support Specialist at AlpinePhysicians

Remote in the Denver or Colorado Springs area.

The Member Support Specialist is responsible for connecting members and providers with existing health services to effectively navigate and maximize their use of the health system.

Essential Functions:

• Liaises between Health First Colorado members, health systems, medical providers and the CCHA Member Support Services call center in order to navigate the medical home system of care
• Provides customer service for member inquiries, to include answering eligibility and enrollment questions, administering health needs assessments, identifying barriers and presenting solutions, and triaging patients to a higher level of care coordination
• Provides customer service for physical and behavioral health provider inquiries, to include answering questions and connecting providers with available resources across the health system
• Triages incoming care coordination referrals by assessing level of urgency, reviewing and documenting needs
• Meets required inbound and outbound call statistics and documentation requirements

• Develops strong telephonic relationships with members to include educating members on proper use of the health care system, providing and/or arranging appropriate referrals to medical and non-medical services, and completing timely telephonic follow-up

• Participates in team meetings
• Maintains confidentiality and ensures compliance with HIPAA regulations
• Other duties as assigned

Knowledge, Skills and Abilities:

• Excellent verbal and written communication skills
• Great customer service skills
• Teamwork skills
• Independent problem-solving skills
• Self-motivated and self-managed
• Good computer and research skills
• Working knowledge of social determinates of health
• Proficient in Microsoft Office Suite

Qualifications:

• High School Diploma or GED
• 1-3 years’ experience in customer service
• Previous experience working in a health care setting (preferred)
• Bilingual; fluent in English and Spanish (preferred)
• Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures