Member Services Representative - West Coast only
About The Position
ArchWell Health is an innovative healthcare provider focused on improving the lives of senior members through accessible neighborhood clinics and wellness-focused care. The Member Services Representative helps members navigate the healthcare system by verifying their primary care physician and eligibility, and by contacting insurance plans when needed to ensure members are assigned to ArchWell Health. The role may also involve managing provider data and verifying ArchWell Health provider information with insurance partners. The ideal candidate has knowledge of the healthcare ecosystem, strong attention to detail, and a passion for supporting seniors.
Requirements
- Proficient PC skills, including Microsoft Office and Excel.
- Passion for helping senior members successfully carry out care plans.
- Ability to work effectively with diverse populations, including staff, providers, members, family members, insurance carriers, vendors, and the public.
- Basic medical terminology knowledge.
- Understanding of Medicare Advantage.
- High school diploma or equivalent (GED) required.
- At least one year of healthcare work experience required, ideally related to benefits and insurance.
Nice To Haves
- Experience with eClinical Works or a similar EMR.
Responsibilities
- Contact members and insurance partners by phone to verify members are assigned to ArchWell Health and schedule appointments.
- Document all member and payer outreach appropriately.
- Help members resolve potential issues related to the healthcare system.
- Validate provider data on file with insurance partners.
- Use and manipulate shared Excel spreadsheets to track membership and interactions.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
