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Elderwood/Pediatric/PostAcute/Woodmark Customer Service Representative in Buffalo, New York

Join our strong and growing company today!

Immediate opening for a Member Service Representative/Customer Service Professional in Buffalo, NY!

Elderwood Health Plan is currently seeking a Member Service Representative to join our managed long-term care interdisciplinary (MLTC) team. In this role, you are responsible for providing customer service for the non-clinical aspects of our Members’ person-centered plan of care. This is a critical role as this Member Services/ Customer Service Representative will serve as the primary point of contact for our Members.

#readytowork #customerservice #memberservices

Our Member Service Representatives (MSR) are responsible for the non-clinical aspects of an EW Health Plan members’ person-centered plan of care and will serve as the primary point of contact of customer service for members. An important part of this role is maintaining a high level of professionalism and establishing a rapport with every member

Other tasks include:

  • Assisting with Member concerns

  • Handling Member inquiries

  • Completing necessary authorizations and triaging calls to the necessary team

  • Interacting/partnering with other departments including claims, intake, enrollment, and provider services to resolve member and provider issues

  • Assisting the Care Management Team with the following:

  • discharge preparation

  • request clinical information

  • arranging transportation

  • coordinating medical supply delivery

  • creation of authorizations within electronic medical record

  • Participating in special projects as assigned, such as Disease Management, Utilization Management, and Quality Improvement activities

  • Identifying barriers to member care and elevating awareness of Member or Provider need and collaborating with team to develop solutions

  • High School Diploma or equivalent; an associate degree preferred

  • Minimum one (1) year experience within an MLTC or Health Care setting

  • Minimum of one (1) year experience working with a diverse and medically fragile population

  • Proficient computer skills, including working knowledge of Microsoft 365 and electronic medical record (EMR)

401K Retirement Plan with Company Match, Clean, Neat & Newly Renovated Facility, Close to thruway entrances/exits, Conveniently located on a bus route, Enjoy a fun and diverse work environment, Enjoy being a part of a strong and diverse team, Free On-Site Parking, Generous PTO & holiday package, Life Insurance, Medical, Dental, and Vision insurance, Point-earning employee reward program: redeem for prizes!, Relaxing employee lounge with free iced/hot coffee, Strong leadership, Substantial employee referral program

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Requisition ID: 2021-16729

Shift: Mon-Fri, 9am-5pm

Street: 500 Seneca St

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