Job Description

Location: Health Choice Management Co.
Posted Date: 10/7/2020

Position Purpose: The Retention Specialist provides customer service to Health Choice members by initiating calls to greet new members, promote member relation with plan and collect member’s satisfaction information all while meeting monthly goals. Job duties include, but are not limited to:

  • Adhere to HIPAA laws at all times; notify Privacy Officer immediately upon learning of a real or potential breach of protected health information.
  • Achieve and maintain customer gratification during initial Welcome Call / New Member Survey
  • Conducts dis-enrollment surveys to assess member’s satisfaction, and document any issues to improve existing customer satisfaction in efforts to retain membership.
  • Complete/Request necessary forms such as HIPAA, Health Risk Assessment, Fraud Waste & Abuse, Grievance, Case Management, PCP Assignments, and various reports
  • Ensure all initiated out-going member calls are documented/call-coded to track effectiveness and efficiency across the department in coordination with development of process improvement efforts in identified areas.
  • Conduct quarterly Service Verifications calls to verify billed services were performed by the billing provider and received by the respective member
  • Serve as back-up for Member Services Representative as necessary

Education / Experience / Other Requirements

Education:

  • High School Diploma or equivalent GED preferred

Years of Experience:

  • At least one (1) year customer service preferred
  • At least one (1) year in call center environment preferred

Specialized Knowledge:

  • Microsoft Office (Word, Excel)
  • Proficient computer skills, typing, and multi-systems navigation
  • Knowledge of Medicare and Medicaid regulations and guidelines preferred
  • Excellent verbal and written communication skills
  • Active listening skills, highly empathetic, conflict resolution skills
  • Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames
  • Prefer Bilingual in Spanish

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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