Member Service Specialist - Hybrid

Focus Care, Inc is a Boston-based, privately-owned national healthcare services company that has been in business for 25 years. We identify and document high risk conditions of Medicare and Medicaid members, to improve health outcomes and achieve accelerated reimbursement for health plans. Our expansive, national provider network includes nurses at all levels of practice (LPN/LVN, RN and NP). Our leadership team and clinical staff have demonstrated success in working with all health care programs, especially government programs (Medicaid, Medicare), risk adjustment, network development and care management. Since 2008, Focus Care has conducted thousands of evaluations nationally, contracting with several health plans. Nearly ten years ago, Focus Care transitioned its hospital nurse staffing business to a broader offering with emphasis on Medicare Advantage health risk evaluation and revenue maximization services.

Qualifications –

• A desire to work in a fast paced, efficient, and results oriented call center environment
• A strong work ethic and autonomy to stay on task, highly motivated to achieve productivity goals.
• Good communication skills, friendly and conversational with members.
• High level of discretion, ability to maintain confidentiality
• A willingness to comply with a fixed daily schedule, including start, break, lunch, and end times
• An ability to take direction and receive critical feedback
• A shown skillset with regards to Data Entry and Integrity of Data, proficiency with the MS Office Suite of applications. Ability to type on average 60 words per minute.
• A desire to showcase your abilities within a training environment with relation to workflows, staying on task, and best practices for the position.
• A proven ability to multi-task and operate within multiple parameters at one time while maintaining data integrity and discretion.
• A desire to work directly with client reporting, data validation, and maintain a working relationship with Focus Care Business Partners.
• An ability to aid management and assist with day-to-day operations of the campaign.
• Must display aptitude for critical thinking, as well as problem-solving acumen.

Responsibilities –

• As a member of Focus Care, you will be responsible for contacting members of various Health Plan Providers by phone to offer, explain, and ultimately schedule them for either Provider or at – Home Healthcare Based Appointments.
• Adjusting and Resetting appointment dates and times, as required
• Work diligently to meet department goals for productivity, quality, and overall success rate.
• Handle a high volume of outbound calls placed by our provided phone system, and fully explain the services offered to them.
• Handle a high volume of inbound calls to answer member questions as well as other customer service activities
• Return voicemail messages from members to schedule appointments as well as other customer service activities
• Occasionally lead classroom training environments going over company systems, best practices, and how to demonstrations relating to the workflows of the project.
• Occasionally shadow in 1:1 training environments, observing, and offering help and support to those who may need it.
• Work within your campaign’s team to assist with questions and best practices. Often while maintaining your own quality of work, data integrity, and discretion.
• Work with Team Lead to assist with client reporting, data validation, and client contact to answer questions as well as other inquiries they have about the success of our campaign.
• Ability to participate in bi-weekly meetings about the status and success of the campaign with contact center upper management as well as Focus Care Business Partners.
• Follow approved scripting and talking guidelines when discussing healthcare-based appointments with members, ensure members understand and are comfortable with the information provided.
• Present a positive face to health plan members, and other members of the workforce.
• Leverage Focus Care Systems to maintain member information and appointment information accurately.
• Report member complaints and issues immediately through appropriate, company approved channels.
• Be responsible for the security and privacy of all protected health information that may be accessed during normal working hours.
• Be available, accessible, and accountable to work during established working hours. Follow support processes, comply with organizational structure and security standards, training, performance management routines, and remote monitoring policies.

Job Type: Full-time

Pay: $17.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Shift:

• 8 hour shift

Weekly day range:

• Monday to Friday

Work setting:

• Hybrid work

Education:

• High school or equivalent (Required)

Experience:

• Medical scheduling: 1 year (Preferred)
• Microsoft Excel: 1 year (Required)
• Customer Support & Client Services Occupations: 1 year (Required)
• Data entry: 1 year (Required)
• Call center: 1 year (Required)

Work Location: Hybrid remote in Woburn, MA 01801