Member Retention Associate

Elevance Health•Washington, DC

2d•$22 - $32•Onsite

About The Position

Responsible for providing customer service to promote retention of members enrolled in Individual product lines. This candidate will be onsite at our Wellness center in Washington D.C.

Requirements

Requires a minimum of 3 years experience in life and health insurance sales and/or member services field; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

Previous experience with Member retention services strongly preferred
Excellent communication and collaboration experience is a must
Experience handling grievances strongly preferred
Previous experience or exposure to health plan and Benefits strongly preferred
Previous experience with Salesforce preferred

Responsibilities

Provide information related to Covered Services, accessing care, and enrollment status
Provide information on how to access services for mental health and substance use disorder
Assist any Enrollee to file a Grievance or Appeal if the Enrollee Services staff is unable to resolve the issue
Schedule appointments and arrange transportation and language access accommodations for medical appointments. if requested and if necessary. The Contractor shall not restrict Enrollees’ access to this service and may not establish requirements that such requests be made more than five (5) calendar days in advance for non-EPSDT appointments and two (2) days for well-child visits and other Medically Necessary Services
Assist Enrollees in selecting a PCP or PDP, or locating another Network Provider
Provide information on contacting the Ombudsman for assistance with filing a Grievance or Appeal
Schedule services and arrange transportation and language access accommodations necessary for pre-approved Out-of-Network Providers. The Contractor shall ensure that its Enrollee Services staff has access to current information about all Providers in the network, including mental health Providers.