Premium Assist Specialist, Healthcare, Remote

Role Summary:

Premium Assist Specialists build relationships and work with health plan members and patients that are eager to learn more about Centauri's services and determine eligibility for benefits. PA Specialists interpret and clarify information such as eligibility requirements and application details, and also determine what additional support may be required. PA Specialists will initiate procedures to refer patient/member to other agencies for assistance as appropriate. The PA Specialist advocates and assists Medicare beneficiaries apply to and requalify for government assistance programs. The PA Specialist builds trusting relationships with members to provide critical application assistance. PA Specialists must be compassionate and understanding while providing patients and health plan members with the highest level of customer service.  

Role Responsibilities:

• Makes outbound and receives inbound calls providing detailed information about eligibility services and conducts eligibility screening
• Conducts telephonic outreach activities for members who need to apply or recertify and are potentially eligible for various Medicaid programs including the Medicare Savings Programs
• Collaborates with government offices to accurately complete the application and recertification process
• Secures documentation for Medicaid/MSP renewal applications if needed for members
• Interviews patients/members via phone to gather personal/sensitive information in order to determine eligibility for various programs
• Interprets and explains information such as eligibility requirements and application details
• Clarifies eligibility data with patient or member
• Compiles, records, and evaluates personal and financial data in order to verify completeness and accuracy
• Utilizes the computer system to accurately complete the screening for eligibility and disposition the account as required
• Initiates procedures to refer patient/member to other agencies for assistance as appropriate
• Interviews patients/members via phone to gather personal/sensitive information in order to determine eligibility for various programs
• Interprets and explains information such as eligibility requirements and application details
• Clarifies eligibility data with patient or member
• Compiles, records, and evaluates personal and financial data in order to verify completeness and accuracy
• Utilizes the computer system to accurately complete the screening for eligibility and disposition the account as required
• Monitors actions to ensure goals are met
• Understand and agree to role-specific information security access and responsibilities
• Ensure safety and confidentiality of data and systems by adhering to the organizations information security policies
• Read, understand and agree to security policies and complete all annual security and compliance training

Role Requirements:

• Bilingual preferred (Spanish and English); fully fluent reading, writing, speaking
• Medicare/Medicaid program experience, and experience with screening for Medicaid eligibility a strong plus
• 1+ years in a Call Center environment, inbound and outbound
• 1+ years experience working with call queues 
• 2+ years Customer Service experience
• Empathy and desire to help others
• Strong decision making skills
• Ability to provide a private and quiet work environment, and work independently
• Strong attention to detail and follow-through skills
• Experience in healthcare or government benefits or agencies a plus
• Case management experience or related experience a plus
• Highly proficient in MS Office (Outlook, Word, Excel, Teams)
• Strong communication and customer service skills
• Ability to track/monitor/retrieve information on calls