Meridian

  • Member Benefit Coordinator

    Job Location US-MI-Detroit
    Job ID
    2017-4825
    Category
    Member Services
    Business Line
    CMC Corporate
  • Overview

    Who we are:

     

    Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

     

    We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

     

    Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

     

    A Day in the Life of a Member Benefit Coordinator:

     

    Member Benefit Coordinators are the face of our company. They provide the utmost customer service to our members daily. In this role you will help improve the lives of others each and every day by answering member’s questions about their insurance, making referrals, scheduling appointments, and providing outstanding customer service. Meridian Health Plan would not be what it is today without this amazing team of talented individuals and their ability to provide the best customer service around!

     

    You may be interested in this position if you:

     

    Have a passion for helping others.
    Enjoy providing outstanding customer service

    *Training will take place in our Detroit office, full-time Monday through Friday for at minimum two weeks. 

    Responsibilities

    • Our  customer service team currently conducts inbound/outbound telephonic contact with members in a professional manner and maintain phone stats according to departmental goals
    • Assist members and providers based on assigned skills, including authorizations and claims calls
    • Educate members and providers on MHP policies and procedures regarding access to care, grievance and appeal process, eligibility process, HIPAA, rights and responsibilities, and fraud, waste and abuse
    • To be able to provide the best customer service possible, while focusing on educating our members and providers on Meridian Health Plan (MHP) policies and procedures regarding access to care, grievance and appeal process and eligibility process
    • Consistently demonstrates compliance with HIPAA regulations, professional conduct and ethical practice
    • Provide excellent customer service to members, providers, and internally to all Caidan Management Staff
    • Act as a liaison between providers and members on all issues
    • Remain updated on all member and provider policy changes made by MHP, the State, or accrediting entities
    • Welcome new members to MHP monthly and ascertain member medical needs to ensure a smooth transition to the MHP network
    • Perform accurate data entry into MHP systems and software programs
    • Understand and be able to maneuver through the MHP member handbooks
    • Work with transportation and PCP offices to schedule members’ appointments as needed
    • Make appropriate referrals to other departments when necessary
    • Assist members through Live Chat and email, as assigned
    • Cross train on all other product lines of MHP to provide assistance as needed
    • Process Member Data Changes, State File Changes, Member Services Faxes, or other assigned to-dos in a timely fashion, if assigned
    • May represent MHP in the community at outreach events such as health fairs, etc.
    • Weekend (Friday – Sunday) shifts cover holidays and/or observed holidays
    • All other shifts may be required to work holidays and/or observed holidays as requested by leadership

    Qualifications

    What you can bring to Meridian:

    • Bachelor’s degree or Fellow designation from the Academy for Healthcare Management (AHM) or job-related certification is preferred.
    • Six months to one year of customer service experience or related health care industry experience is required.
    • Basic knowledge of managed care or Medicaid programs is helpful
    • Familiarity with Medical Terminology is preferred 
    • Excellent customer service skills and both verbal and written communication skills are required
    • Intermediate computer skills are required  
    • Ability to effectively and clearly communicate with callers is required

    What Meridian can offer you:

     

    • Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.
    • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
    • Meridian offers 401k matching that is above the national average.
    • Full-time Meridian employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.
    • Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.

     

    Equal Opportunity Employer

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