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Member Services Specialist
Curana HealthResponding to member and provider inquiries about Medicare benefits and claims. Working within Curana Health's contact center to resolve issues and maintain relations.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in health insurance benefits and Medicare regulations, with strong capabilities in customer service, problem analysis, and effective communication. Proficient in utilizing internal systems for documentation and data analysis to enhance member/provider relations.
Highest-signal resume keywords
Health Insurance ExperienceMedicare ExperienceCustomer Service SkillsCompliance With CMS RegulationsProficient Written And Oral Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data AnalysisProblem SolvingDocumentation ManagementDatabase ManagementMicrosoft Office Suite Proficiency
Soft Skills
Interpersonal SkillsOrganizational SkillsTeam CollaborationIndependent Work
Industry Keywords
Medicare BenefitsMedicare Advantage PlansCall Center ExperienceMember/Provider RelationsOperational Challenges
About the role
Key responsibilities & impact- Responds to Member/Provider questions via telephone and written correspondence regarding Medicare benefits, enrollment questions, change requests, eligibility, and claims
- Analyzes problems and provides information/solutions
- Utilizes internal systems to obtain and extract information, documents information, activities, and changes in the database
- Thoroughly documents inquiry outcomes for accurate tracking and analysis
- Develops and maintains positive member/provider relations and coordinates with various functions within the company to ensure requests and questions are handled appropriately and in a timely manner
- Researches and analyzes data to address operational challenges and member/provider service issues
- Requires knowledge of health insurance benefits
- Seeks, understands, and responds to the needs and expectations of internal and external customers
- Create and manage documentation specific to contact center
- Other duties as assigned
Requirements
What you’ll need- H.S. graduate or GED
- Health insurance experience required
- Medicare experience preferred
- Medicare Advantage plans experience is a bonus
- Customer service and Call center experience preferred
- Proficient written and oral communication skills required
- Compliance with CMS regulations regarding Medicare Advantage Plans
- Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team
- Exceptional organizational skills
- Proficiency in computer skills including Microsoft Office Suite products
Benefits
Comp & perks- Health insurance
- 401(k) matching
- Paid time off