Member Benefit Coordinator - Weekend OperationsJob Location US-MI-TroyJob ID 2018-5149Category Member ServicesBusiness Line CMC Corporate Overview Who we are: Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry. We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide. Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities. A Day in the Life of a Member Benefit Coordinator:Member Benefit Coordinators are the face of our company. In this role you will help improve the lives of others each and every day by answering members questions about their insurance, making referrals, scheduling appointments, and providing outstanding customer service. Meridian Health Plan would not be what it is today without this amazing team of talented individuals! You may be interested in this position if you:Have a passion for helping othersEnjoy providing outstanding customer serviceHave a desire to learn and grow in a healthcare environment Responsibilities Conduct inbound/outbound telephonic contact with members in a professional manner and maintain phone stats according to departmental goalsAssist members and providers based on assigned skills, including authorizations and claims callsEducate members and providers on MHP policies and procedures regarding access to care, grievance and appeal process, eligibility process, HIPAA, rights and responsibilities, and fraud, waste and abuseEducate members and providers on Meridian Health Plan (MHP) policies and procedures regarding access to care, grievance and appeal process and eligibility processConsistently demonstrates compliance with HIPAA regulations, professional conduct and ethical practiceProvide excellent customer service to members, providers, and internally to all Caidan Management StaffAct as a liaison between providers and members on all issuesRemain updated on all member and provider policy changes made by MHP, the State, or accrediting entitiesWelcome new members to MHP monthly and ascertain member medical needs to ensure a smooth transition to the MHP networkPerform accurate data entry into MHP systems and software programsUnderstand and be able to maneuver through the MHP member handbooksWork with transportation and PCP offices to schedule members appointments as neededMake appropriate referrals to other departments when necessaryAssist members through Live Chat and email, aif assignedCross train on all other product lines of MHP to provide assistance as neededProcess Member Data Changes, State File Changes, Member Services Faxes, or other assigned to-dos in a timely fashion, if assignedMay represent MHP in the community at outreach events such as health fairs, etc.Weekend (Friday Sunday) shifts cover holidays and/or observed holidaysAll other shifts may be required to work holidays and/or observed holidays as requested by leadership Qualifications What you can bring to Meridian:Bachelors degree or Fellow designation from the Academy for Healthcare Management (AHM) or job-related certification is preferred.Six months to one year of customer service experience or related health care industry experience is required.Basic knowledge of managed care or Medicaid programs is helpfulFamiliarity with Medical Terminology is preferred Excellent verbal and written communication skills are requiredIntermediate computer skills are required Ability to effectively and clearly communicate with callers is requiredWhat Meridian can offer you:Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.Opportunity to work with the industrys leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.Meridian offers 401k matching that is above the national average.Full-time Meridian employees are eligible for tuition reimbursement towards Bachelors or Masters degrees.Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian. Equal Opportunity Employer