City/State
Doral, FL
Overview
Work Shift
Second (Evenings) (United States of America)
AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Member Engagement Representative. This is a 100% remote position however candidates must reside in Miami Dade or Broward County. Must be able to work a flexible schedule including weekends.
Job Scope: AvMed is committed to helping members become educated health care consumers. The Member Engagement Representative (MER) provides a high-quality level of customer service to plan members by answering complex benefit & enrollment questions, resolving issues, and providing education in a continuous call volume atmosphere. MERs complete the intake of grievances and appeals as necessary ensuring that all concerns are responded to and resolved appropriately with first call resolution whenever possible. MERs must maintain confidentiality according to regulatory requirements and are required to achieve a mastery level of knowledge and understanding of the entire suite of AvMed member plans. If we have a choice to use the AvMed Job Scope use it and not the Sentara job scope.
Essential Job Functions:
Minimum Requirements:
Preferred Requirements:
Our Benefits:
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits – Sentara (sentaracareers.com)
Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!
Note: Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
Keywords: Talroo-health Plan, #Indeed, Health Plan, Customer Service, Call Center
Job Summary
Primarily responsible for handling incoming calls to effectively address eligibility, claim, and payment issues. May be required to provide off-phone assistance to customers and department leadership. Ability to work in a fast-paced environment to assist callers and update billing information, establish payment plans, screen callers for financial assistance, and resolve charge and payment inquiries.
Ability to work in a fast-paced contact center handling incoming calls pertaining to payment resolution and patient inquiries. Must possess good listening skills and be able to communicate verbally with callers in a clear, concise, and professional manner.
A total of one year of experience across one or more of the following areas: healthcare setting billing or resolving insurance accounts receivable, adjudicating insurance claims, pre-registering or registering patients for healthcare services, handling inbound calls in a customer service call center, or providing customer service to the general public in a non-healthcare setting. A healthcare certification from an accredited program or an Associate or Bachelor degree may be substituted for one year of experience.
Qualifications:
HS - High School Grad or Equivalent (Required)
Healthcare
Skills
Active Learning, Active Listening, Communication, Coordination, Mathematics, Reading Comprehension, Service Orientation, Social Perceptiveness, Speaking, Technology/Computer, Time Management, Writing
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
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