Senior Member Services Representative (Care Navigation & Advocacy)

Posted 3 days ago

rose internationalHyattsville (MD)

Customer Service Representatives Direct Health and Medical Insurance Carriers

SENIORITY

Senior

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About the role

Senior Customer Service Representative

Job Description: Required/Preferred Education High School Diploma/Associate degree Expected Shift: 8:00 AM 5:00 PM EST Specific Systems Knowledge Required: MCT Any Required Certifications: NoTop Three things Worker will be doing Answer member calls, Outbound calls and responding to emails Top Three Skillsets needed Care Navigation & Member Advocacy, Complex Issue Resolution & Escalation Management and Benefits & Product Expertise Anything else important we need to know to fill your role: We need someone who has a KP background and have great customer service skills Specific Systems Knowledge Preferred MCT, HP CHATS, Health Connect and MQVJob Overview The Senior Customer Service Representative will provide specialized concierge-style member advocacy, care navigation, network navigation, and service support for members enrolled in a Choice Product insurance plan. This role serves as a primary member contact, delivering a high-touch service experience through proactive outreach, ongoing issue resolution, complex care coordination support, and ongoing member engagement. The position will work collaboratively with clinical, operational, and service teams to help members navigate benefits, access care and services, resolve complex issues, and achieve a seamless experience throughout their participation in the pilot program.

Interview Process:

2 people via teams
Only those lawfully authorized to work in the designated country associated with the position will be considered.
Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.

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