Medicare Service Coordinator

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched 401k retirement saving program
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement and CEU credits.

What You Will Do

• Leads effort to maximize member retention. Receives inbound and conducts outbound calls to members indicating a desire to cancel or disenroll from VNS Health Plans Medicare. Resolves complex member related issues escalated by front line customer service staff. Identifies root cause for members requesting disenrollment. Independently take all necessary actions to retain member in plan within established guidelines.
• Collaborates with members, providers, and internal staff to identify and resolve member service and retention related concerns. Educates constituents on plan features and benefits.
• Notifies sales staff of potential enrollment cancellations and "rapid disenrollments" (those in plan less than 3 months). Supports sales related efforts to retain members. Coordinate with sales staff to reinforce messaging to enrollees, members, care givers and other constituents.
• Acts as senior member of VNS Health Plans Medicare customer service team. Maintains expertise in VNS Health Plans Medicare benefits, network and organization structure. Acts as a resource to members to guide them on how to access their Medicaid benefits. Advises and serves as a resource for Medicare Service Coordinators and other staff in the resolution of member related issues.
• Analyzes situations to ensure resolution of immediate problems and prevention of anticipated problems. Elevates broader issues to senior management as necessary.
• Develops, implements and produces ad hoc and standardized reports on call center performance, satisfaction, member retention, sales broker performance, MGA management, appointed representatives and commission reports. Trends and analyzes reports as appropriate.
• Maintains up-to-date configuration and ensures synchronization of supporting systems such as salesforce.com and FIS. Summarizes data from a wide range of electronic and other sources into consolidated data stores.
• Coordinates and administers telephonic member satisfaction surveys. Develops survey tools and summarizes results.
• Responds to supplemental benefits requests. Enters authorizations into appropriate systems. Researches problem solve and collaborates with providers to service delivery issues.
• Coordinates member retention efforts including conducting member retention calls and mailings. Develops member retention materials.
• Organizes member affinity activities, including member appreciation and recognition events and promotions.
• Provides administrative and telephonic support to Medicare Advantage departments as needed.
• Ensures compliance with the VNS Health Plans Medicare Advantage policies and procedures as well as all CMS regulations.
• Participates in special projects and performs other duties as assigned.

Education:

• Bachelor's Degree in Business or other related discipline or equivalent work experience required

Work Experience:

• Minimum five years healthcare, insurance or business operations experience required
• Proficiency in personal computer applications, including Microsoft Access, Word and Excel required
• Bilingual skills preferred