Job Overview
Employment Type
Full-time
Compensation
Type:
Hourly
Rate:
Range $21.00 - $28.00
Work Schedule
Standard Hours
Benefits
Health Insurance
Dental Insurance
Paid Time Off
Retirement Plan
Employee assistance program
Professional Development
wellness programs
Job Description
Alignment Health is a pioneering healthcare company dedicated to transforming the way healthcare services are delivered to seniors, the chronically ill, and the frail. As an innovative health plan provider, Alignment Health focuses on putting seniors first by offering personalized, comprehensive care solutions through a compassionate and highly skilled team. The company is recognized for breaking the mold of traditional healthcare by fostering an environment of growth, innovation, and a strong community spirit dedicated to making a meaningful difference in members' lives. Alignment Health's commitment extends beyond routine care; it aims to improve health outcomes by coordinating care across various... 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 plus words per minute
- Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
- Ability to communicate positively, professionally and effectively with others
- Effective written and oral communication skills
- Ability to establish and maintain constructive relationships with diverse members, management, employees and vendors
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals
- Ability to write routine reports and correspondence
- Ability to speak effectively before groups of customers or employees of the organization
- Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
- Ability to deal with problems involving a few concrete variables in standardized situations
- Ability to perform mathematical calculations and calculate simple statistics correctly
- Effective problem solving, organizational and time management skills
- Ability to work in a fast-paced environment
- Preferred bilingual in English/Spanish, English/Vietnamese or English/Mandarin
- Fluency in written and verbal Spanish, Korean, or Vietnamese a plus
Job Qualifications
- High school diploma or GED
- Minimum 1 year of customer service experience
- Knowledge of ICD-10 and CPT codes
- Keyboard typing 40 plus words per minute
- Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
- Ability to communicate positively, professionally and effectively with others
- Effective written and oral communication skills
- Ability to establish and maintain constructive relationships with diverse members, management, employees and vendors
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals
- Ability to write routine reports and correspondence
- Ability to speak effectively before groups of customers or employees of the organization
- Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
- Ability to deal with problems involving a few concrete variables in standardized situations
- Ability to perform mathematical calculations and calculate simple statistics correctly
- Effective problem solving, organizational and time management skills
- Ability to work in a fast-paced environment
- Preferred bilingual in 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
- Places regular/consistent outreaches to the patient
- Communicates with PCP with any member updates and requests
- Assists with obtaining medical records from any healthcare providers involved in care or hospitals
- Helps members with any authorizations and referrals involved in their care plan
- Resolves incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs
- Coordinates membership changes such as member’s primary care physician and proactively engages member with their wellness plan options
- Participates in on-site member engagement activities as needed, such as in-person member meetings, handling lobby calls at a retail or care center location
- Other duties as assigned
Job Qualifications
Experience
Entry Level (1-2 years)
Job Location
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