RA Member Engagement Representative

SOUTHLAND CARE COORDINATION PARTNERS INCOlympia Fields, IL
Onsite

About The Position

The Clinical Risk Adjustment Program Member Engagement Representative engages health plan members and schedules Risk Adjustment appointments.

Requirements

  • High School Diploma or Equivalent Required.
  • Minimum of 1 year of Call Center Representative Experience Preferred.
  • Minimum of 2 years in a Customer Service Role Required.

Nice To Haves

  • Excellent verbal communication skills.
  • Ability to interact with health care professionals in a professional manner.
  • Computer Literate – Word, Google Doc and Excel.
  • Able to multi-task, manage time and set priorities.
  • Able to remain coachable and teachable at all times.

Responsibilities

  • Engage health plan members and employ professional techniques during verbal communications, electronic correspondence, and text-based interactions with each member.
  • Assist health plan Members with scheduling appointments with the Nurse Practitioners (NP’s).
  • Update and maintain accurate documentation of each member’s encounter in the electronic health record (EHR).
  • Accurately document appointments.
  • Properly execute member referrals/concerns/grievances when applicable.
  • Document timely member observations requiring administrative notification of any critical member issues/concerns.
  • Interact with staff and members to optimize workflow efficiency.
  • Compliant with Performance Goals / Contract Deliverables.
  • Help promote a company culture that encourages top performance and high morale.
  • Follow all Policies and Procedures of SCCP.
  • Participate in all SCCP mandatory and CMS regulatory training.
  • Attend all staff meetings – in person or via telephone (if unable to attend, responsible for knowledge of content).
  • Develop a comprehensive understanding of SCCP information security policies.
  • Abide by all SCCP information security policies, procedures, protocols, and practices.
  • Abide by principles and laws related to confidentiality.
  • Report information security risks when they are identified.
  • Participate in regular information security management trainings.
  • Develop a comprehensive understanding of SCCP information security policies.
  • Abide by principles and laws related to confidentiality.
  • Demonstrate respect for individual diversity (culture, ethnicity, gender, race, religion, age, economic status).
  • Engage in continuing education and training for professional growth and development.
  • Other duties as assigned by Direct Report.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume

What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

1-10 employees

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service