Job Overview
Employment Type
Full-time
Compensation
Type:
Salary
Rate:
Range $47,029.00 - $70,544.00
Work Schedule
Standard Hours
Benefits
Health Insurance
Dental Insurance
Paid Time Off
Retirement Plan
Employee assistance program
Professional Development
Flexible Schedule
Job Description
Alignment Health is a pioneering healthcare company devoted to transforming the way healthcare is delivered to seniors, as well as those who are chronically ill and frail. With a strong commitment to putting the senior first, Alignment Health focuses on serving this vulnerable population segment by building a compassionate and dedicated team united by a shared mission. The company operates as a health insurance provider, specializing in Medicare Advantage plans and supplemental benefits that aim to meet the unique healthcare needs of seniors. Alignment Health is considered a fast-growing organization, offering ample opportunities for professional growth and innovation within the... Show More
Job Requirements
- High school diploma or GED
- Minimum 1 year of customer service experience
- Knowledge of ICD-10 and CPT codes
- Keyboard typing 40+ words per minute
- Ability to help members navigate healthcare through Medicare Advantage or HMO including referrals and authorizations
- Ability to communicate positively and effectively
- Effective written and oral communication skills
- Ability to establish constructive relationships with members, management, employees and vendors
- Ability to apply common sense to carry out written or oral instructions
- Effective problem solving and organizational skills
- Ability to work in a fast-paced environment
- Preferred bilingual skills in English/Spanish, English/Vietnamese, or English/Mandarin
Job Qualifications
- High school diploma or GED
- Minimum 1 year of customer service experience
- Knowledge of ICD-10 and CPT codes
- Keyboard typing 40+ words per minute
- Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
- Ability to communicate positively and professionally
- Effective written and oral communication skills
- Ability to establish and maintain constructive relationships with diverse members, management, employees, and vendors
- Ability to apply common sense understanding to carry out detailed written or oral instructions
- Effective problem solving, organizational and time management skills
- Preferred bilingual English/Spanish, English/Vietnamese, or English/Mandarin
- Fluency in written and verbal Spanish, Korean or Vietnamese a plus
Job Duties
- Provides in-market specialized member support in respective market or region
- Conducts in-market member engagement including welcome calls, new member onboarding, JSA scheduling, high quality PCP and provider terms, product/vendor changes, CAHPS proxy, disenrollment quality assurance, and proactive service recovery
- Conducts case follow-ups and quality member issue resolution for all cases assigned
- Ensures members have access to PCP and specialists to coordinate care
- Educates members on gaps in care and assists with scheduling provider appointments
- Serves as the patient’s liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures
- Makes appropriate and timely patient appointments, reminders, and confirmations and mails letters and correspondence as needed
Job Qualifications
Experience
Entry Level (1-2 years)
Job Location
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