
ProfessionalServices - MemberRelationship Liaison
Immediate need for a talented ProfessionalServices - Member Relationship Liaison. This is a 03+months contract opportunity with long-term potential and is located in U.S(Remote; PSt/ MST). Please review the job description below and contact me ASAP if you are interested.
Job ID: 25-59708
Pay Range: $30 - $32/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Requirements and Technology Experience:
- Key skills; Member outreach, claims, health insurance, supervisor/lead experience
- Serve as the day-to-day contact for assigned health plans, interacting with Members.
- Providers and Health Plan Leaders to facilitate problem resolution and promote high client satisfaction
- Bachelor s degree in related field or equivalent experience.
- 2+ years of data management or data analytics experience.
- Supervisor/lead experience preferred.
- Utilize multiple systems to investigate escalated inquiries on Members/Providers and follow the Member/Provider experience from beginning to resolution
- Manage resolution of activities in CRM, including HICS from CMS according to defined turnaround times
- Collaborate with internal teams and external partners to resolve complaints and document issue and resolution in CRM
- Conduct Member/Provider outreach based on a variety of trends such as frequent caller data and out of network claim denials
- Ensure compliance with State and Federal laws, following State and Federal guidelines as well as the procedures for the plans and the Corporation
- Recommend workflows and policy as a result of Member/Provider feedback and escalation data analysis
- Work cross functionally with internal departments regarding client needs and requests, work procedures, gaps in policy, and other elements of supporting assigned clients and conduct member, provider and health plan telephonic education as needed
- Document appropriate client specific information in CRM
- Performs other duties as assigned
- Complies with all policies and standards
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
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