Member Experience Clerk

Member Experience Support Clerk page is loaded## Member Experience Support Clerk remote type:
Office Full Time locations:
Orange, CAtime type:
Full time posted on:
Posted 3 Days Agojob requisition :
R1482

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Member Experience Support Clerk is responsible for providing daily clerical support to the Member Ser-vices Department including but not limited to; the Member Services Representatives, Transportation Unit, Member Outreach Unit, and Appeals and Grievances Team.
** Job Duties/Responsibilities:
*** Tracks incoming member correspondence in the department mail log & EZ Member database.
* Assigns a MS Representative as appropriate for follow up including “Request for Assistance” forms from the Sales/Marketing Dept daily.
* Tracks the incoming Health Risk Assessment Surveys into the EZ Member database and logs all HRA Vitamin Coupons.
* Maintains the departments miscellaneous filing in an organized fashion and create files for new staff as needed.
* Maintains the inventory of department supplies ( Stock, PCP Change Forms,  Holders, Birthday Cards, Transportation Postcard Reminders, etc.,) and orders supplies as needed.
* Maintains daily, monthly department mailings including but not limited to, birthday cards, anniversary cards, condolence cards, and miscellaneous mailings.
* Acknowledges and logs the receipt of all grievances, appeals, and CTM (Complaint Tracking Module). Provides clerical support to the Appeals and Grievance Coordinator.
* Assembles, maintains & protects member A&G case files in an organized fashion.
* Faxes grievance response requests to appropriate parties for the gathering of all pertinent and relevant information from the provider regarding the grievance/appeal.
* Provides follow up calls to providers and/or IPA and members as appropriate to ensure compliance with timelines set forth to ensure CMS compliance.
* Logs point of contacts of providers and/or IPA and members.
* Performs other duties clerical or otherwise as assigned by the Department Manager.

Supervisory Requirements:

None.
*
* Job Requirements:

***
* Experience:

*
* •

Required:

Minimum 1 month of related experience and/or training; or equivalent combination of education and experience.
• Preferred:
None.
*
* Education:

*
* •

Required:

High School Diploma or GED.
• Preferred:
None.
** Training:*
* •

Required:

None.
• Preferred:
None.
** Specialized

Skills:

*
* •

Required:

* Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans.
* Bilingual (English/Spanish) required.
* Basic Computer Skills, 30 WPM (Microsoft Outlook, excel, word).
* 10-Key by Touch.
* Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
* Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
* Mathematical

Skills:

Ability to perform mathematical calculations and calculate simple statistics correctly.
* Reasoning

Skills:

Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
** Licensure:*
* •

Required:

None.
• Preferred:
None.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform…