The Healthcare Support Specialist is responsible for providing compassionate and comprehensive support to members within the Medicare line of business.
The role serves as the primary point of contact, assisting members in navigating healthcare services, scheduling appointments, arranging transportation, resolving benefit inquiries, and ensuring compliance with healthcare policies and procedures.
Job Description
• Manage inbound and outbound calls, assisting members with inquiries, benefit plan details, and issue resolution.
• Guide members through the healthcare process, including scheduling appointments, referrals, and transportation coordination.
• Provide accurate information about health plan policies, coverage, and procedures.
• Build strong rapport with members through active listening, empathy, and clear communication.
• Document all interactions and maintain accurate records in compliance with company and regulatory standards.
• Identify opportunities to improve communication and education for members.
• Support billing resolution, benefit clarification, and escalate issues when needed.
• Ensure compliance with Medicare guidelines, HIPAA, and other healthcare regulations.
• Deliver service excellence by demonstrating professionalism, accountability, and empathy.
• Perform additional ad hoc tasks and support department initiatives as required.
Required Qualifications
• Clear and coherent both written and verbal communication skills in English, to provide courteous assistance to patients, healthcare providers, and colleagues.
• Navigate healthcare processes, benefit structures, and compliance requirements.
• Experience documenting cases and maintaining accurate records.
• Demonstrates strong attention to detail, organization, and adherence to compliance standards.
• Problem-solving and critical thinking skills to resolve complex member concerns.