Consumer Service Operations Representative-- REMOTE/100% WORK FROM HOME (WA, WY, UT, ID, OR, MT)

Description

The Consumer Service Operations Representative 3 will be a concierge for new members to Humana for members in the Intermountain Region. They are responsible for supporting members throughout their health journey and the daily activities across multiple service functions area. The Concierge will have advanced administrative/operational/customer support duties that require independent initiative and judgment and play a critical role in creating and developing this new concierge program.

Responsibilities

Responsibilities

Consumers have come to expect personalized and seamless experiences in nearly all aspects of their daily life - how they stay connected, shop, book travel, and manage their finances. Consumers should expect, and will demand, the same personalized experience for managing their health. Be a part of creating a customer-focused experience designed to foster a trusting relationship with new members to help them achieve their best health.

We are seeking individuals who are passionate about solving big problems in healthcare for new members. As a member of this interdisciplinary care team, you will have the opportunity to bring your "A game" to work every day to improve the lives and health of the members we serve.

The Consumer Service Operations 3 will have the opportunity to develop close relationships with our members in order to serve as the quarterback of the care team. You'll serve as the primary point of contact for our members, assisting them with all their needs. As a trusted confidante, you are their champion, their hero - and you've got their back. You will help to redefine the care that we provide for seniors - working to meet their financial, social, emotional, and medical needs.

This role requires experience working with people and providing them exemplary customer service. We are looking for individuals who are passionate about transforming our care system for patients; those who are willing to thoughtfully disrupt the status-quo and excited to work in a rapidly evolving start-up environment; and are driven to do well by doing what's right.

Within a dynamic customer-focused team, the Concierge will work closely with in market professionals and community resources to help our members negotiate the complexities of today's healthcare environment. You will guide them through their healthcare journey, ensuring they get the care they need so they can focus on their life's ambitions and goals.

The Consumer Service Operations Representative 3 (Concierge) may perform installation, implementation, client support, client services, client administration, customer service, enrollment, and eligibility, claims processing, and call center operations (this includes outbound calling as well as inbound). Investigates claims and customer service issues. Decisions are typically focus on methods, tactics, and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques. Works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.

Responsibilities

• Function as a consultant and concierge to members
• Help members navigate their health plan and benefits
• Assess the member's current state within the context of their history
• Listen, understand, and advise on every call
• Develop relationships with members and their circle of family, friends, and caregivers
• Build rapport with your care team to work together on the member's behalf
• Communicate as needed with members' medical providers and community resources
• Collaborate with your team to support member inquiries through chat, email, and voice
• Scheduling appointments, provide members education on screenings, AWV, etc.
• Helps to improve New Member Concierge program by providing feedback, recommendations, and ideas for areas of program improvement.
• Helps inform market leadership on areas of opportunity for benefit utilization and design.

A successful candidate will be member centric and passionate about advocating and helping members throughout their healthcare journey. They will be empathetic, understanding, patient, and communicate clearly. They will take the extra step to help members and establish relationships both with members and within the care team.

Required Qualifications

• Excellent verbal, listening, and written communication skills, and ability to use discernment to help members and solve problems.
• Prior customer service experience, including typing/data entry.
• Aptitude for quickly learning and navigating new technology, systems, and applications.
• Proficient in Microsoft Office, Outlook, and Word.
• Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems.

Preferred Qualifications

• STRONGLY PREFERRED: Familiarity with medical terminology and/or ICD-10 codes
• CNA, Medical Assistant, or social work background
• Quality background
• Medicare experience
• Experience working with complex care management teams
• Experience working with an interdisciplinary team

Work-At-Home Requirements

• Open to remote locations
• Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Additional Information - How We Value You
• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Go365 perks for well-being

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

#ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40