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Beneficiary Engagement Specialist
1 month ago
Overview
The purpose of this position is to support the ABC and VBCare Network Medicare and Medicaid engagement and relationship building programs, manage and address member inquiries, complaints, make outreach calls, request for information from health centers, as necessary assist the Manager, Program and Business Operations, and meet and greet visitors to the Chauncey Office.
This may include helping to navigate beneficiaries through the Medicare system and advocating and resolving beneficiary complaints. Position requires a knowledge of Medicare program benefits and excellent customer engagement skills.
This position is required to work in the office at 6910 Chauncey Lane, Phoenix.
Responsibilities
Makes and manages beneficiary outreach calls and public phone calls, review and triages correspondence, responds to e-mails regarding Medicare beneficiary questions, addresses beneficiary inquiries, resolves complaints, and processes beneficiary grievances with management.
Provides explanations to members and others regarding ACO REACH program ABC Network, opportunities to voluntarily enroll in ABC Network, and any benefit enhancement or benefit incentives that are available under the program which may include sending promotional and informational materials to members requesting it.
Documents member contacts in customer relations software system.
Coordinates with appropriate ABC Network and VBCare Network staff or participating provider staff to resolve member issues and document the issue resolution.
Prepares member response letters and correspondence regarding actions taken.
Participate in training programs for health center staff regarding beneficiary engagement and improving beneficiary relations.
Reports any significant issues or complaints related to medical treatment to the Medical Director and appropriate management.
Participates in CMS approved outreach and marketing efforts for increasing the number of voluntary enrollments.
Qualifications
A minimum of an associate degree in social service, health service, nursing, or counseling.
Three- year experience as a hotline counseling, health navigator, health educator, or insurance broker representative, or Medicare or patient advocate.
Experience with behavioral interviewing techniques.
Experience with MS Office, Power Point, and Excel.
Must be a Permanent Arizona resident.
Bi-lingual Spanish speaker required
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Able to read and write Spanish desired.
Valid Arizona Drivers License.
Must be detailed oriented.
Must be an excellent communicator, both verbal and written.
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