Member Services Coordinator

Job Description

Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. Curative is looking for a Member Services Coordinator who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in the medical field/Customer Care by increasing satisfaction and retention by providing Curative health plan Members, patients, and providers with accurate, consistent, timely and meaningful information. They will provide support to Members’ while building rapport and collaborative relationships with current and prospective Members in accordance with compliance guidelines. This is a remote position with multiple shift options in a 24/7 call center.
ESSENTIAL DUTIES AND RESPONSIBILITIES:

Answering high volume phone calls and emails, assisting and resolving Member related requests regarding but
not limited to the following:
Building and maintaining solid member relationships by handling questions, concerns, resolving
issues/complaints with speed and professionalism while maintaining confidentiality per HIPAA guidelines
in a fast paced inbound and outbound phone, email, and text message call center environment.
PPO Insurance plan interpretation and benefits
Managing and updating database Member information with 100% accuracy
Enrollment, claims, benefit interpretation, EOB’s, provider selection, and referrals/authorizations for
medical services and prescriptions.
Flexibility with changing process and policies requiring excellent organizational skills for immediate
recall of information
Handling calls and emails for all inquiries, we are a one stop shop for support and issue resolution
 Documents provider and member complaints, determines appropriate course of action, and
follows-up to ensure the complaint is resolved.
Provides Member/Provider outreach calls for issue resolution and follow ups
Documents all interactions and transactions with the member in the appropriate areas.
Assists Members with Provider assignments and re-assignments.
Work adhering to US regulatory and Quality System requirements.
This position assumes and performs other duties as assigned.

WORK SHIFTS AVAILABLE:
Shift flexibility required. Shift availability based on staffing needs, no guaranteed shifts

Available shifts options are:
○ Pre 6am – 2:30 cst
○ AM 8am – 4:30 cst
○ Mid Shift 10am – 6:30 cst
○ PM shift 3:30-midnight cst
Available Days of the week options are:
○ Days of the week: Sunday – Thursday
○ Days of the week: Tuesday – Saturday
○ Days of the week: Friday – Monday

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty with excellence. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions:

Excellent attendance is critical to success in this position
High volume Call Center phone, email, and text messaging experience
Previous healthcare/Insurance experience preferred
Excellent computer and phone skills, attention to detail, process and policy adherence
Excellent verbal and written communication skills.
Strong interpersonal skills.
Active listening skills to accurately respond to inquiries and requests.
Exceptional organizational skills, retention of policy and process a must
Intermediate skills minimum in google and microsoft office suite of products a must
Experience with internal communication systems such as Slack, Microsoft Team, etc…
 Internal candidates must have been in their current role for at least 6 months and have no performance or
attendance actions in effect.

EDUCATION and/or EXPERIENCE:

Only candidates meeting experience requirements will be considered
One year minimum related experience in a high volume phone, email, text messaging call center
environment
 Call center experience in healthcare, medical device, and/or biotech industries preferred

CERTIFICATES, LICENSES, REGISTRATIONS – Administrative/Healthcare a plus but not required
WORK ENVIRONMENT:

Remote position
Must have password protected, stable high speed internet access – stipend will be provided
Must have a quiet place, with no distractions to perform duties for work from home
Work location MUST be secure and private to maintain HIPAA compliance for work from home
Office equipment will be supplied including: PC, monitor, keyboard, mouse, headset
While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or
feel; talk; and hear.
 The employee is frequently required to reach with hands and arms.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral
vision, depth perception and ability to adjust focus.
We also request, with the exception of emergencies, that you do not request any time off within the first
120 days of employment. Any request within the first 120 days if approved will be unpaid
For this position the percentage of expected Travel is:0% of the time

TRAINING EXPECTATIONS:

You will attend a 4-5 week minimum remote training program.
Attendance is mandatory for the full training program
 Training will be Monday through Friday 8:30am – 5pm PST
You will be required to take regular open book competency and retention exams intermittently during all
weeks of training. Passing grades are 90% or above.
We also request, with the exception of emergencies, that you do not request any time off within the first
120 days of employment. Any request within the first 120 days, if approved, will be unpaid