Healthcare Service Coordinator

4 days ago


Miami, Florida, United States Solis Health Plans Full time
Job Overview

Solis Health Plans is a cutting-edge Medicare Advantage Company that offers innovative solutions to enhance the healthcare experience for its members and providers. Our team is comprised of expert individuals who take pride in delivering exceptional service. We believe in a collaborative culture that supports one another, where success is interlinked, and each employee is valued.

The Member Services Representative role is a pivotal position within our organization, primarily responsible for providing quality, professional service to customers via telephone, written or in-person inquiries. This individual will be the face of Solis Health Plans, ensuring that member satisfaction is met while adhering to Plan guidelines.

Key Responsibilities
  • Handle customer inquiries in a courteous, professional, thorough, and timely manner.
  • Assist callers with coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, medical group/PCP, explanation of how the plan works, and referrals or authorizations.
  • Maintain customer service levels (abandonment rate, speed of answer, and service level) within established parameters.

This role requires a strong understanding of plans benefits, CMS policies, and procedures. The ideal candidate will possess excellent communication skills, attention to detail, and the ability to manage multiple tasks simultaneously.

Requirements and Qualifications

To succeed in this role, an individual must have:

  • A minimum of a High School diploma or equivalent.
  • At least 1 year of healthcare experience, preferably with plan experience.
  • Working knowledge of HIPAA regulations.
  • Excellent communication, interpersonal, verbal, and written communication skills.
  • Familiarity with healthcare laws, regulations, and standards.

We offer a comprehensive compensation package, including an estimated $55,000 - $65,000 per annum, depending on location and experience. Additionally, we provide full benefits, a 401K plan with a 100% company match, and opportunities for growth and development.



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