Member Services Outbound Specialist

2 weeks ago

Chicago, United States Homeward Full time

Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don't have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we're rearchitecting the way it's delivered - leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.

Most importantly, we're aligning everyone's incentives (ours, partner health plans', and members') towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member's healthcare and outcomes.

Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

**The Opportunity**

Join us in tackling healthcare for rural America We seek a compassionate and detail-oriented Outbound Call Member Specialist to join our dedicated Member Services team. As an Outbound Call Member Specialist, you will play a vital role in supporting our mission by reaching out to prospective and current members via telephone to introduce members to Homeward's health navigation services.

As a member of our centralized Operations team, you will work closely with our in-market teams and cross-functionally with other centralized teams to support prospective and current members in meeting a variety of needs. You will be the first point of contact with our prospective and current members and offer a welcoming, empathetic, and helpful experience.

**What You'll Do**:

- Conduct outbound calls to prospective and current members to build awareness of Homeward's Care Navigation services.
- Schedule appointments for members using our platform, ensuring accuracy and efficiency.
- Assist members in registering demographic and insurance information in our electronic health record platform.
- Verify insurance coverage with members' insurance companies for all healthcare visits.
- Ensure complete and accurate filing of member documents, maintaining detailed records of all transactions.
- Field and appropriately transfer clinical inquiries to the Clinical team, demonstrating professional judgment and attention to detail.
- Identify and execute additional projects and processes to enhance efficiency and scalability within the Member Services department.
- Uphold departmental SLAs and service standards, ensuring a high level of member satisfaction.
- Clearly document all member-related communication and activities for reference and follow-up.

**What You Bring**:

- Minimum of 1+ years experience in a healthcare call center or appointment scheduling environment
- Exceptional attention to detail, with the ability to listen and respond appropriately to member needs and concerns
- Excellent communication skills, with the ability to interact effectively with various stakeholders and convey information clearly
- Empathetic, member-first attitude and approach, demonstrating patience and understanding in every interaction
- Proficiency with healthcare-related platforms such as Athena EHR is a plus
- Familiarity with ZenDesk or similar customer service platforms is preferred
- Ability to use professional judgment to escalate potentially emergent clinical phone calls to the Clinical team
- Experience working in a remote environment and with virtual care offerings is advantageous
- Strong familiarity with referrals and prior authorizations is a plus.
- Highly detail-oriented: you routinely catch the little things that others miss or overlook
- Empathetic, member-first attitude and approach as you help our members and potential members navigate healthcare

**Bonus Points**:

- Proficiency with the Athena EHR platform
- Outbound call center experience, specifically in a healthcare call center
- Proficiency with the Athena EHR platform
- Working knowledge of ZenDesk
- Experience working in a remote environment and with virtual care offerings
- Strong familiarity with referrals and prior authorizations
- In-depth knowledge of Medicaid, Affordable Care A

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