Member Services Specialist

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Curana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

⚕️ Healthcare Insurance

Healthcare • B2B • Healthcare Insurance

Curana Health is a healthcare provider focused on senior primary care and on-site clinical services in skilled nursing and senior living communities. The company partners with operators, payors, and Medicare Advantage plans to implement value-based care models, offering physician-led care teams, medical director services, care coordination (including RPM and APCM), behavioral health, and palliative care. Curana emphasizes reducing hospital readmissions, falls, and polypharmacy while improving resident satisfaction through integrated, community-based care supported by technology and payor partnerships.

📋 Description

• Responds to Member/Provider questions via telephone and written correspondence regarding Medicare benefits, enrollment questions, change requests, eligibility, and claims • Analyzes problems and provides information/solutions • Utilizes internal systems to obtain and extract information, documents information, activities, and changes in the database • Thoroughly documents inquiry outcomes for accurate tracking and analysis • Develops and maintains positive member/provider relations and coordinates with various functions within the company to ensure requests and questions are handled appropriately and in a timely manner • Researches and analyzes data to address operational challenges and member/provider service issues • Requires knowledge of health insurance benefits • Seeks, understands, and responds to the needs and expectations of internal and external customers • Create and manage documentation specific to contact center • Other duties as assigned

🎯 Requirements

• H.S. graduate or GED • Health insurance experience required • Medicare experience preferred • Medicare Advantage plans experience is a bonus • Customer service and Call center experience preferred • Proficient written and oral communication skills required • Compliance with CMS regulations regarding Medicare Advantage Plans • Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team • Exceptional organizational skills • Proficiency in computer skills including Microsoft Office Suite products

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off