Healthcare Representative

Job Summary: 

The Healthcare Representative is responsible for making outbound calls daily to eligible health plan members to confirm eligibility and enroll them into available health benefits. 
This role focuses on proactive member outreach, benefits education, and accurate enrollment using existing member lead lists. This role requires a strong understanding of various health plans, empathetic interaction with members, and adherence to healthcare regulations and organizational standards. 

Duties/Responsibilities: 

Make outbound calls daily to existing lists of potential or eligible health plan members to support benefit enrollment. 

Confirm eligibility status and onboard health plan members for additional benefits. 

Ensure daily, weekly, and monthly productivity goals are met. 

Discuss new health plan benefits with members and their family/support persons. 

Navigate and utilize multiple health plans’ EMR system. 

Treat members with empathy and respect, adhering to their religious and cultural preferences. 

Assist the care coordination team with developing health interventions and interacting with involved departments to expedite scheduling and completion of health care consult. 

Comply with organizational guidelines, healthcare laws, and regulations, including HIPAA by fostering nursing practices that adhere to the nursing division’s standards of care. 

Maintains quality service by enforcing organization standards. 

Perform other duties as assigned. 

Education and Experience: 

High school diploma or GED required; Bachelor’s degree preferred. 

Minimum of 1 year of sales experience required (healthcare experience preferred). 

Bilingual in English and Spanish preferred. 

Required Skills/Abilities:  

Excellent communication, interpersonal, customer service, and organizational skills. 

Proficient computer skills and experience with Microsoft Office. 

Maintain empathy and professionalism while contacting members and families. 

Physical Requirements:  

Prolonged periods sitting at a desk and working on a computer. 

Must be able to lift up to 10 pounds at times.