Member Services Specialist (Hybrid)
Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don’t have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.
Our vision is care that enables everyone to achieve their best health. So, we’re rearchitecting the way it’s delivered – leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.
Most importantly, we’re aligning everyone’s incentives (ours, partner health plans’, and members’) towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member’s healthcare and outcomes.
Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.
Join us in tackling healthcare for rural America! We’re seeking a Member Services Specialist who is passionate about having a positive societal impact and using technology for good – solving issues of health inequity for communities that have been perennially underserved.
As a member of our centralized Operations team, you will work closely with our in-market teams in Michigan and Minnesota and cross-functionally with other centralized teams to support prospective and current members in meeting a variety of needs. You will be the first point of contact with our prospective and current members and offer a welcoming, empathetic, and helpful experience.
What You'll Do:
- Provide non-clinical telephone support to Members and potential Members
- Schedule appointments for Members
- Register demographic and insurance information in the electronic health record platform
- Run insurance verification with Member’s insurance company for all visits
- Process prior authorizations
- Receive, send, and manage Member referrals
- File Member documents ensuring complete and accurate information
- Process payments and copays. Maintain detailed and accurate records of financial transactions, and perform end-of-day processes and reports
- Field and transfer clinical inquiries to the Clinical team with appropriate detail and judgment
- Maintain basic knowledge of remote patient monitoring device functions and troubleshooting
- Identify and execute additional projects and processes to create efficiencies and scale for the Member Services department
- Maintain department SLAs and standards of service
- Clearly document all patient-related communication and activity
What You Bring:
- 1+ years of support experience in a Primary Care setting
- In-depth knowledge of Medicare, Medicare Advantage, and Medicare Dual Special Needs Plans
- Experience using professional judgment to escalate potentially emergent clinical phone calls to the Clinical team
- Highly detail-oriented: you routinely catch the little things that others miss or overlook
- Exceptional communication skills to support work with different groups of stakeholders and communicate process and progress to the organization
- Empathetic, member-first attitude and approach as you help our members and potential members navigate healthcare
- Located in one of our hub locations: Austin, Chicago, San Francisco, or Minneapolis
- Proficiency with the Athena EHR platform
- Working knowledge of ZenDesk
- Experience working in a remote environment and with virtual care offerings
- Strong familiarity with referrals and prior authorizations
- College degree
- In-depth knowledge of Medicaid, Affordable Care Act, or other government health plans
What Shapes Our Company:
- Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
- Compassion and empathy
- Curiosity, and an eagerness to listen
- Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
- Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
- Nurturing a diverse workforce, with a wide range of backgrounds, experiences, and points of view
- Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!
- Competitive salary, equity grant, Unlimited PTO
- Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
- Company-sponsored 401k plan
- Flexible working arrangement, with offices in the Bay Area, Chicago and Austin
Salary Range is $50,000 - $60,000 annually.
At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.
Homeward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.