Remote Sr. Customer Service Advocate

Position Overview

AHI agilon health, inc. is seeking a Remote Sr. Customer Service Advocate. In this role, you will manage multiple outbound call campaigns under the MSO structure and directly interact with patients/members, health plans, and providers. You will be responsible for executing call campaigns that impact the organization’s overall performance by effectively handling inquiries, scheduling appointments, ensuring medication adherence, and providing exceptional customer service.

Job Posting Location: Remote - USA | Work Location: Remote - California

Key Responsibilities

• Make outbound member calls to support various call campaigns including:
  • Attribution – PCP confirmation or assisting a member to select a PCP
  • Disruption – notifying patients of health plan termination and connecting them with a broker
  • Appointment scheduling – assisting patients in scheduling an annual wellness visit
  • Medication adherence – discussing medication supply and connecting patients to enroll in mail order delivery
• Conduct 3-way calls with patients and health plans for attribution campaigns.
• Handle inbound calls from Medicare FFE members and complete detailed call documentation for quarterly CMS reporting.
• Perform outbound ‘secret shopper’ calls to verify appointment availability at practice locations.
• Call dialysis centers to confirm submission of required information to CMS and record submission dates.
• Make outbound calls within CMS timeframe requirements to notify members of medication approval.
• Access and navigate multiple systems simultaneously while interacting with patients.
• Shift between call campaigns without compromising quality.
• Think critically when determining final call disposition and document calls accurately.
• Troubleshoot system/data issues to ensure proper campaign targeting.
• Escalate patient/member concerns appropriately to management.
• Maintain a calm demeanor during all customer interactions.
• Adapt quickly to respond appropriately to member questions or concerns.
• Strive to meet target success rates for each call campaign.
• Complete outbound calls in a timely manner in accordance with performance standards.
• Facilitate communication via the Language Assistance Program for non–English proficient members, including arranging interpretation services for the hearing impaired.
• Forward calls to supervisors or other staff when further follow-up is required.
• Ensure confidentiality of all communications and adhere to privacy policies.
• Promote a positive image of the organization in all interactions.
• Participate in regular training to maintain and enhance program knowledge.
• Perform other related duties as assigned.
• Other Job Functions include:
  • Adhering to and implementing company policies and procedures.
  • Delivering excellent customer service by understanding and meeting client needs.
  • Taking personal responsibility for professional growth and skill enhancement.
  • Engaging in attentive and professional communication.
  • Setting and achieving challenging goals.
  • Demonstrating attention to detail and producing accurate work.

Required Qualifications

• Minimum of 12 months experience in customer/member services or a related function in a healthcare organization is preferred.
• Experience with conducting outbound member calls.
• Experience in a managed care environment is preferred.
• Demonstrated expertise in customer service including excellent verbal and written communication skills, handling difficult communications with skill, and delivering clear, concise, and customer-focused messages.
• Bilingual in English/Spanish is preferred.
• Minimum educational requirement: High school diploma; some college coursework is preferred.

Compensation

• Pay Range: $18.40 - $22.10 per hour (guideline). Individual compensation packages may vary based on skill set, experience, and qualifications.