Member Services Specialist

Job Description:

Member Services Specialists are the first point of contact for youth, families/caregivers and providers. They are responsible for answering all calls within a specific service level agreement and completing the registration process as well as managing questions from treatment providers. Member Services Specialists determines the appropriate routing of the call and attempts to be the first point of resolution. This position is also responsible for maintaining consistent procedures and providing outstanding customer service.

Work Arrangement/Schedule

• Fully Remote; must be able to accommodate Saturday and Sunday 3:00pm-11:00pm Eastern Time Zone
• Required Training will take place during 1st and 2nd shift hours at a minimum of 14 hours a week

Key Responsibilities

• Answer incoming calls and provide information about PerformCare’s operations and services.
• Complete intake documentation for Members accurately and efficiently.
• Explain procedures for accessing behavioral health services.
• Address Member complaints by initiating the PerformCare Grievance and Complaint process.
• Explain Member rights upon request and provide additional resources, including the Member Handbook and provider lists within the Member’s geographic region.
• Enter requests and authorizations into the system accurately.

 Education & Experience

• Bachelor’s degree (BS or BA) from an accredited college or university required. 
• 1 to 3 years of behavioral health experience preferred.
• Strong written and verbal communication skills; ability to respond sensitively to Member inquiries preferred.
• Previous customer service and data entry experience desired, preferably in a call center environment.
• Minimum of one year of experience in mental health and/or human services preferred. 
• Proficiency in Windows-based PC applications.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.