Supervisor Member Services

Job ID
2021-170894
Employment Type
Full Time
Department
Member Services
Hours / Pay Period
80
Facility
Dignity Health Management Services Organization
Shift
Day
Standard Hours
Monday through Friday
Work Schedule
8 Hour
Location
CA-Bakersfield

Overview

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

Responsibilities

This role  will assist the Customer Service Manager with daily operations of the Customer Service department to ensure goals and standards are met, including personnel management, production control, and compliance of health plan and CMS regulations.

Qualifications

What experience will successful candidates have? See below!

Minimum

    • High school diploma or equivalent required.

    • Three or more years’ experience working in medical group, IPA, health plan, or physician’s office in the areas of customer service, or provider relations and/or experience working in a managed care environment working with authorizations, claims, eligibili

    • Thorough understanding of medical benefits, medical terminology, diagnosis and procedural coding with ability to interpret and communicate complex contract or benefit language.

    • Familiar with QNXT or equivalent integrated claims processing system.

    • Strong kn

Preferred

  • Associate Arts degree in a relevant field such as business administration or healthcare preferred.

  • High volume call center experience preferred.

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