Member Support Specialist

Job not on LinkedIn

🔥 12 hours ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $35.5k - $56.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💝 Customer Support

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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PACIFICSOURCE

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Serve as a resource to members with complex psychosocial issues that create barriers to medical-regimen adherence and optimal health outcomes • Work telephonically and in person as an integral part of the case management team • Develop and implement member goals and plans in coordination with case managers • Educate members about understanding and working within their benefit structure • Use motivational interviewing and patient-engagement techniques to support optimal health outcomes • Identify community resources and make appropriate referrals • Serve as liaison between members and providers/agencies • Identify members for coordination and case management services using claims data and reports • Screen requests for appropriate case-management referrals • Collaborate with the case management team and participate in care-coordination meetings • Maintain compliance with state and federal regulations, HIPAA standards, and confidentiality requirements • Maintain accurate and timely documentation • Assist with referrals, appointment scheduling, and transportation to medical appointments • Assist members with non-clinical needs during transitions and phases of care • Manage mailing lists and outgoing mailings • Assist with departmental procedures, reports, projects, and quality measures • Enter and collate data and prepare assigned reports • Participate in committees and quality-improvement initiatives • Make presentations to small groups • Perform other duties as assigned

🎯 Requirements

• Minimum of three years of experience in community services or healthcare agencies focused on coordination services • Experience in health insurance and delivering group presentations preferred • High school diploma or equivalent required • Knowledge of medical terminology • Proficient in Microsoft Office, including Word, Excel, and PowerPoint • Experience with medical management software, such as CaseTrakker Dynamo • Excellent verbal and written communication skills • Ability to work independently and effectively on a team • Good working knowledge of how to access community resources and the healthcare system • Ability to meet department and company performance and attendance expectations • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing, sorting and filing, and lift and carry files and business materials • Ability to travel approximately 20% of the time