Member Services Specialist - Part Time (12:00 pm - 4:00 pm EST)

Company Overview

Curana Health strives to significantly enhance the well-being, happiness, and respect of elderly individuals. As a recognized national leader in value-based healthcare, Curana Health serves senior living communities and skilled nursing facilities with comprehensive solutions, including onsite primary care, Accountable Care Organizations, and Medicare Advantage Special Needs Plans. Since its inception in 2021, the company has rapidly expanded to support over 200,000 seniors across more than 1,500 communities in 32 states. The workforce consists of over 1,000 clinicians and various professionals collaborating to deliver exceptional care and operational efficiency. Curana Health recently ranked #147 on the Inc. 5000 list of America's fastest-growing private enterprises.

Role Summary

This part-time role involves addressing inquiries from members and providers via phone and written communication pertaining to Medicare benefits, eligibility, claims, and enrollment. The position requires problem analysis, issue resolution, thorough documentation of interactions, maintenance of accurate records, timely follow-ups, and fostering positive relationships. Collaboration with different departments to resolve service challenges and contributing to contact center documentation are also essential.

Key Responsibilities

• Address member and provider questions concerning Medicare benefits, enrollment, eligibility, claims, and change requests through telephone and written communication.
• Analyze inquiries and provide appropriate information or solutions.
• Use internal databases and systems to retrieve, document, and update information and activities accurately.
• Maintain detailed records of inquiry outcomes to enable proper tracking and analysis.
• Support positive interactions with members and providers and coordinate with multiple internal teams to ensure timely and correct handling of requests.
• Research and assess data to resolve operational and service-related challenges.
• Adhere to knowledge of health insurance benefits, particularly Medicare standards and regulations.
• Continuously seek to understand and respond effectively to customer needs and expectations.
• Develop and manage documentation specific to contact center functions.
• Perform additional duties as assigned.

Qualifications

• High school diploma or GED required.
• Experience in health insurance is mandatory.
• Medicare experience is preferred; familiarity with Medicare Advantage plans is a plus.
• Customer service and call center experience are advantageous.
• Strong verbal and written communication abilities are essential.
• Strict compliance with CMS regulations for Medicare Advantage plans is required.
• Excellent interpersonal skills with ability to work independently and collaboratively in a team environment.
• Superior organizational abilities.
• Proficiency with Microsoft Office Suite and computer operations.

Additional Information

Curana Health is firmly committed to Equal Employment Opportunity and values diversity in all employment practices, prohibiting discrimination based on race, color, creed, religion, national origin, citizenship status, age, gender, sexual orientation, disability, veteran status, or any other status protected by law. The company does not offer visa sponsorship. Recognition includes ranking as the 147th fastest-growing private company by Inc. magazine, highlighting its contributions to transforming senior housing and care quality.