The primary goal of the Member Liaison is to efficiently and effectively manage the follow-up process of our Social Security applications and ensure we have collected the corresponding information/documentation to receive an approval on the applications submitted. Responsibilities include, but are not limited to:
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Accountable for managing an entire caseload of pending applications to be processed and monitored daily.
Responsible for all member and government agency outreach activities that will drive an open application to a positive outcome (approval). These activities primarily include member and government agency calls and letters to complete outstanding verifications.
Maintain working relationships with government agencies and act as a liaison for members.
Responsible for following up with government agencies to obtain application status information and advocate for the expedition of a final decision.
Use reports and queries to manage and prioritize caseload and ensure benchmarks are being met.
Evaluate and initiate action on aging cases. Responsible for escalating problem cases when necessary.
Ensure data quality and work with supervisors as an active participant in identifying and resolving problems and inconsistencies.
Support supervisors in the implementation of new processes and training initiatives.
Provide an enhanced level of customer service to our members and clients.
Educate and counsel members on Social Security processes and respond to inquiries around the status of the application/approval.
Enter, update, and maintain demographic and application information in our proprietary database system while maintaining accuracy.
Responsible for updating the "Contact Log" in our proprietary database system to ensure outreach attempts, contacts, interactions, and assessments have been properly captured.
Accountable for processing rendered approvals and denials.
Responsible for preparing the corresponding support documentation for any appeal process as part of our Denial Management initiatives.
Assist in other team member training and provide feedback during cross training opportunities to enhance the department’s functionality, roles and training materials.
Participate in Department and HFI Committees and Projects as assigned by the Operations Manager/Supervisor.
Other duties may be assigned.
4-year degree in related field or equivalent combination of education and experience.
Bilingual (English/Spanish), preferred.
At least 1 year of previous experience in a customer service/call center role, strongly preferred.
At least 1 year of previous experience in a healthcare setting, strongly preferred.
Familiarity with medical terminology, preferred.
Previous experience with health insurance, preferred.
Self-motivated, responsible, and accountable.
Identifies own learning needs and seeks appropriate assistance.
Excellent computer skills including: MS Office.
Ability to work well within a fast-paced, team-oriented environment.
Willingness and ability to work extra hours during a workweek as required.
HFI is strongly committed to diversity and inclusion. We recognize the rich variety of backgrounds, experiences and points of view of a diverse staff that enhances both the quality of the services we provide and the excitement and innovative spirit of our work culture. We are committed to a policy of non-discrimination and equal employment opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, sex, age, disability, veteran’s status, sexual orientation and/or genetic information.
Working hours are Monday-Friday from 11:00 - 7:00 PM or 12:00 - 8:00 PM. Over-Time opportunity for special projects on planned Saturday/Sunday hours.
Eight (8) hours p/day excluding breaks.
Job Status: Full Time