Member Services Representative

Job Details

Job Details

Job Ref:
R0062143
Location:
Cedar Crest Village by Erickson Senior Living, 1 Cedar Crest Dr, Pompton Plains, NJ 07444
Category:
Resident Services

Location:

Cedar Crest Village by Erickson Senior Living

Cedar Crest is a beautiful 130-acre continuing care retirement community nestled in the Ramapo Mountains in Pompton Plains, a neighborhood of Morris County, New Jersey. We’re part of a growing network of communities developed and managed by Erickson Senior Living, a national provider of senior living and health care with campuses in 11 states—and growing.  

The Member Services Representative supports the Erickson Advantage Plan as a member service liaison and assists care coordination inclusive of: telephone triage, referral service arrangement, risk assessment, and scoring, production of reports, authorizing services for members, assisting and facilitating as needed to meet the health care and wellness needs of the Erickson Advantage Plan members. The Member Services Representative serves as a resource for members who require assistance with administrative issues related to their Plan membership, including facilitating the resolution of claims, premium billing, and enrollment issues in collaboration with Evercare/United Healthcare partners. 

How you will make an impact:

  • Manage inbound calls and walk-in contacts with members, responsible parties, and providers/vendors for the Erickson Advantage Member Services and Care Coordination Office at the Erickson community and document all contacts in the Touchpaper Call Tracking System and Canopy Clinical System as appropriate.
  • Act as a primary resource to health plan members in problem resolution collaborating with the United Healthcare Service Center and other Evercare/United points-of-contact 
  • Arrange for order/delivery of medical equipment, supplies, and services as requested by the Community Care Coordinator or the Primary Care Physician.
  • Manage the new Member Welcome Process by performing initial enrollment contact with new health plan members, reviewing the benefits package, scheduling home visits to address issues not manageable by telephone, and managing the assessment survey process.
  • Serve as a resource for Erickson Senior Living staff about Erickson Advantage benefits and operations through participating in community-wide and departmental meetings and establishing/maintaining positive working relationships with key members of the community team; Medical Center, Resident Life, Community Transportation, Wellness Center, etc.
  • Manage distribution of predefined health plan material, including mailing, follow-up, and data entry of results as appropriate.

​Compensation:

Commensurate with experience starting at $45,000.00/year

What we offer:

  • A "career for life" approach to professional and personal development for our greatest asset; our employees. 
  • A culture of diversity and inclusion, which builds on our values, vision, and mission.
  • Onsite medical centers, providing wellness visits and sick care for all employees over 18 years of age.
  • Free onsite parking at all of our communities and corporate offices
  • Competitive benefits packages including medical, dental, vision, and PTO in accordance with applicable state law.
  • 401k for all employees 18 and over. Company contribution up to 3% once eligible.
  • Education assistance, certification reimbursement, and student loan refinancing partnership programs are available.

What you will need:

  • Previous experience in healthcare or insurance environment required; 4-6 years experience required.
  • Customer service experience required – 1-3 years.
  • AA (Associates of Arts) or related degree required.

Erickson Senior Living, its affiliates, and managed communities are Equal Opportunity Employers and are committed to providing a workplace free of unlawful discrimination and harassment on the basis of race, color, religion, sex, age, national origin, marital status, veteran status, mental or physical disability, sexual orientation, gender identity or expression, genetic information or any other category protected by federal, state or local law.

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This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between the Erickson Senior Living health plans and health care providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.