• Member Benefit Expert

    Job Location US-MI-Detroit
    Job ID
    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.


    Please Note:

    Anyone interested in this position would need to be open to working an afternoon shift. 


    • Work within a call center environment to process incoming and outgoing telephonic contacts with members
    • Adhere to workforce management schedules in order to ensure departmental goals are met
    • Assist with the onboarding of care coordinated members, consisting of welcome calls and the initial health risk screening
    • Complete Questionnaires for Meridian members
    • Serve as a liaison between members and Care Coordination
    • Assist with Face to Face scheduling for Community Care Coordination
    • Assist members with identified needs during telephonic contacts
    • Assist members in navigating their member handbook and benefits
    • Make appropriate referrals to other departments when necessary
    • Work with transportation and PCP offices to schedule members’ appointments as needed
    • Educate members on Meridian policies and procedures regarding access to care, grievance and appeal process, eligibility process, HIPAA, rights and responsibilities, and fraud, waste and abuse
    • Consistently demonstrates compliance with HIPAA regulations, professional conduct and ethical practice
    • Provide excellent customer service during all external and internal telephonic contacts
    • Remain updated on all member policy changes made by Meridian, the State, or accrediting entities
    • Perform other duties as assigned


    What you can bring to Meridian:

    • High School Diploma is required
    • Bachelor’s degree in one of the following areas is preferred: Allied Health, Business Administration (with a focus in Health Services Administration), Health and Fitness Management, Health Sciences (with a focus in Behavioral Health), Health Services Administration, Healthcare Administration, Healthcare Management, Nursing, Nutrition, Public Safety, Pharmacy, Psychology, Public Health or Social Work
    • One year of customer service experience or related health care industry experience is preferred.
    • Basic knowledge of managed care or Medicaid programs is helpful.
    • Familiarity with Medical Terminology is preferred.
    • Knowledge of waiver and high risk populations preferred.
    • Excellent 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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