Member Services Inbound Specialist

Homeward

Minnesota, USA · Remote

Posted on Friday, October 4, 2024

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, 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 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. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

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.

The Opportunity

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

Bonus Points:

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!

Benefits:

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 $45,000 - $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.

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Member Services Inbound Specialist