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Member Services Assistant

Amida Care

Description

The Member Services Call Center Support Assistant position is responsible to maintain integrity of member records, charts and demographics. This role also handles member basic incoming and outgoing correspondence, including but limited to all required mailings, monthly reminders, welcome packets, educational materials, handbooks, and member ID processing. The Member Services Call Center Support Assistant is responsible for the maintenance/updating of member demographic information, prepares forms, and sends information to members for all product lines as required or requested..
A. Technical/Services
• Create and file new member/inactive member charts and records
• Digitizing/Scanning of member charts
• Generate disenrollment report and document EPaces investigative reasons
• Assist/Support MS Eligibility Specialist with Plan Initiated Disenrollment(PID), and Restricted Recipient Program (RRP) across all product lines
• Collaborate with audits of member charts as needed
• File all Member Services member records (i.e. MDR, welcome letters, disenrollment letter, enrollment packet material, incentives letters, term PCP letters, HIV verification and other materials)
• Ensure member confidentiality and adhere to Confidentiality and HIPPA policies and regulations
• Data entry for MS required data documentation
• Generate timely member mailing list (i.e. Incentive letters, PCP unknown letters, Term PCP letters and other mailings) based on State and Federal regulatory requirement.
• Generate monthly mailing list for all new members welcome packets.
• Coordinate all new member fulfillment literature and ensure accuracy.
• Audit fulfillment of New member packets via return mail.
• Process member mailing requests as assigned
• Communicate effectively and timely intra and interdepartmentally to obtain necessary information to complete daily tasks.
• Conduct weekly reviews of member files to determine which files should be sent to storage.
• Review Member Charts to ensure adherence to Article 44 Requirements and report any inadequacies immediately to The Member Services Team Lead and Member Services Manger
• Review and Update all identified invalid member demographics
• Assist w/recertification notice mailing: coordinate with retention //recertification specialist
• Coordinate with eligibility and enrollment specialist to identify duplicate demographics/or to validate member demographics
• Coordinate with to obtain timely notification of pregnant members, minors and newborns.
• Process and Mail new member ID’s as requested
• Assist in securing/obtaining/maitaining/updating and distribution of required MS materials to the MS Dept.(ie: handbooks, blue list, quick reference guide ect.)
• Perform Member Services outgoing call projects as assigned by member Services Manager, Call Center Manager or Member Services Director.
• Follow up and respond to written and verbal member inquires and requests (i.e. incentives, ID cards, PCP change discrepancies)
• Perform other duties as assigned by the Member Services Call Center Manager, Member Services Manager or Director of Member Services.
• Research returned mail, to identify correct addresses for all member returned mail.
• Ensure all actions are apprioately documented in the member contact log.
• Follow up on all inquires submitted via fax that are not benefit or contractually related
• Schedule and call member regarding coordination of transportation for MLTC product.
• Complete outgoing calls for all incentive based healthy reminders.
• PCP changes submitted via MSTEAM
• Send PCP change letters to members
• Process Monthly Healthy Reminder Mailings
• Take initiate to create solutions for time sensitive/and regulatory and high volume projects.
• Complete outgoing fax tasks and requests as required
• Document and Distribute incoming faxes to appropriate recipient
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• Maintain and report accurate inventory counts of all member services supplies (including those required for all member events)
• Process all department requests for supplies from inventoried MS stock.
• Log, inventory and secure all returned incentives
• Document and file all returned mail in database

Qualifications

EDUCATION REQUIRED
• High School Diploma or GED
EXPERIENCE AND/OR SKILLS REQUIRED
A minimum of 2 years office or general clerical experience

Contact

[email protected]

Posted on 10/01/14; CVMHA ID #8205