Member Services Representative (Bilingual Preferred)

Company: ArchWell Health
Location: Nashville
Posted on: April 17, 2024

Job Description:

Member Services Representative (Bilingual Preferred)



Nashville, TN, USA * Virtual
Req #11408



Thursday, March 21, 2024




ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.
Job Summary:
The Member Services Representative (Bilingual Preferred) is responsible for providing outreach to our members to help them navigate the complex healthcare delivery system. This will entail verifying their primary care physician and eligibility and contacting their insurance plan when applicable to ensure they are assigned to ArchWell Health. This role has the potential to handle provider data management and will need to verify AWH provider information with these insurance partners when applicable. An ideal candidate will have a deep understanding of the healthcare ecosystem, have strong attention to detail, and be driven by a passion for providing quality care to seniors.
Duties/Responsibilities:

Outreach to members and insurance partners over the phone to verify members are assigned to ArchWell Health and schedule members for appointments
Complete proper documentation of all member and payor outreach
Assist members in problem solving potential issues related to the health care system
Validate provider data on file with insurance partners
Utilize and manipulate shared Excel spreadsheets to track membership and interactions.

Required Skills/Abilities:

Proficient PC skills to include Microsoft Office and Excel
Passion for helping senior members successfully carry out care plans
Ability to work effectively with diverse populations including staff, providers, members, family members, insurance carriers, vendors, and the public
Basic medical terminology
Understanding of Medicare Advantage
Bilingual in Spanish/English strongly preferred

Education and Experience:

High school diploma or equivalent education (GED) required
A minimum of one year working in healthcare, ideally with experience related to benefits and insurance required
eClinical Works or similar EMR experience preferred

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.






Other details



Job Family
Clinical Shared Services

Pay Type
Hourly






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Keywords: ArchWell Health, Nashville , Member Services Representative (Bilingual Preferred), Other , Nashville, Tennessee