Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!
Position is FULLY ON SITE Monday-Friday.Location: 9250 NW 36th St, Miami, FL 33178.**BILINGUAL IN ENGLISH AND CREOLE IS REQUIRED**
Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members!Join our winning Solis Team!
Position Summary:
Solis Health Plans is looking for a Member Services Representative primarily responsible for providing quality, professional service to all customers when calls are received through the Member Services Department via telephone, written or in-person in accordance with Plan guidelines.
Essential Duties and Responsibilities:Handles telephone, written and in-person inquiries in a courteous, professional, thorough, and timely manner to assure member satisfaction.Assists callers on inquiries regarding coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, medical group/PCP, explanation of how the plan works and how to utilize services, assists with information regarding referrals or authorizations, member complaints, identification card requests.Must Report to the Doral HQ.Responsible for maintaining customer service levels (abandonment rate, speed of answer and service level) within established parameters.Is knowledgeable on plans benefit, CMS and Plans policies and procedure.Applies high level of subject matter knowledge to solve a variety of common business issues.Provides quality services effectively to increase the overall level of customer service and satisfaction as measured by CMS.Identifies the differences between a Grievance, Appeal or Coverage Decision and process the request through the appropriate channels.Identify, handle, document and/or route Utilization Management inquiries appropriatelyIdentify and document Coverage Determinations.Documents all inquiries and complaints.Interacts with other departments about member issues or concerns.Approaches work in a meticulous and thorough manner, pays attention to detail and follows company scripts.Manages time effectively and prioritizes tasks to meet deadlines.Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.Ensures compliance with all HIPAA, OSHA, and other federal, state and local regulations.Participates in meetings, trainings and in-service education, as required.Highly regulated environment.Time frames to handle issues are in accordance with CMS time frames.Interacts with members, family members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.Qualification and Education:Minimum of High School diploma or equivalent.Minimum of 1year healthcare experience is required, with a preference for plan experience.Working knowledge of the Privacy and Security Health Insurance Portability and Accountability Act (HIPAA) regulations.Excellent communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.Excellent computer knowledge is required, including proficient knowledge of Microsoft OfficeFamiliarity with healthcare laws, regulations and standards.Ability to compute basic arithmetic and work with numbers.Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.Ability to work effectively independently, work with very little supervision and in a team environment.Ability to read, analyze, and interpret technical procedures or governmental regulations.Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.Ability to define problems, collect data, establish facts, and draw valid conclusions.Strong decision-making, analytical skills.Must be self-motivated, organized and have excellent prioritization skills.Must be able to work well under stressful conditions.Must be able to work in a fast paced environment.Fluency in English and Spanish.
What set us apart:Join Solis Health Plans as a Member Services Representative (Bilingual in Creole) and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!
Position is FULLY ON SITE Monday-Friday.Location: 9250 NW 36th St, Miami, FL 33178.**BILINGUAL IN ENGLISH AND CREOLE IS REQUIRED**
Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members!Join our winning Solis Team!
Position Summary:
Solis Health Plans is looking for a Member Services Representative primarily responsible for providing quality, professional service to all customers when calls are received through the Member Services Department via telephone, written or in-person in accordance with Plan guidelines.
Essential Duties and Responsibilities:Handles telephone, written and in-person inquiries in a courteous, professional, thorough, and timely manner to assure member satisfaction.Assists callers on inquiries regarding coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, medical group/PCP, explanation of how the plan works and how to utilize services, assists with information regarding referrals or authorizations, member complaints, identification card requests.Must Report to the Doral HQ.Responsible for maintaining customer service levels (abandonment rate, speed of answer and service level) within established parameters.Is knowledgeable on plans benefit, CMS and Plans policies and procedure.Applies high level of subject matter knowledge to solve a variety of common business issues.Provides quality services effectively to increase the overall level of customer service and satisfaction as measured by CMS.Identifies the differences between a Grievance, Appeal or Coverage Decision and process the request through the appropriate channels.Identify, handle, document and/or route Utilization Management inquiries appropriatelyIdentify and document Coverage Determinations.Documents all inquiries and complaints.Interacts with other departments about member issues or concerns.Approaches work in a meticulous and thorough manner, pays attention to detail and follows company scripts.Manages time effectively and prioritizes tasks to meet deadlines.Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.Ensures compliance with all HIPAA, OSHA, and other federal, state and local regulations.Participates in meetings, trainings and in-service education, as required.Highly regulated environment.Time frames to handle issues are in accordance with CMS time frames.Interacts with members, family members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.Qualification and Education:Minimum of High School diploma or equivalent.Minimum of 1year healthcare experience is required, with a preference for plan experience.Working knowledge of the Privacy and Security Health Insurance Portability and Accountability Act (HIPAA) regulations.Excellent communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.Excellent computer knowledge is required, including proficient knowledge of Microsoft OfficeFamiliarity with healthcare laws, regulations and standards.Ability to compute basic arithmetic and work with numbers.Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.Ability to work effectively independently, work with very little supervision and in a team environment.Ability to read, analyze, and interpret technical procedures or governmental regulations.Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.Ability to define problems, collect data, establish facts, and draw valid conclusions.Strong decision-making, analytical skills.Must be self-motivated, organized and have excellent prioritization skills.Must be able to work well under stressful conditions.Must be able to work in a fast paced environment.Fluency in English and Spanish.
What set us apart:Join Solis Health Plans as a Member Services Representative (Bilingual in Creole) and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!
**AGENT LICENSE 2-15 (Life, Health & Variable Annuity) or 2-40 (Health), in good standing, REQUIRED*****Medicare Sales Experience Required******Bilingual in English & Spanish is required***Position offers a base salary plus monthly car allowance, cell phone allowance and a generous Sales Incentive Plan!Full benefits package offered on the first of the month following date of hire including: Medical, Dental, Vision 401k plan with a 100% company match!Our company has doubled in size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members.Join our winning Solis Team!
Position Summary:Responsible for advising Medicare Beneficiaries on the plan benefits offered by SOLIS Health Plans.
Essential Duties and Responsibilities:Performs compliant sales presentations to enroll prospective members into the Plan as per Marketing Policies and Procedures while complying with State and Federal Guidelines.Ensures only Medicare Approved Materials are used during presentations.Conducts in-person appointments at participating medical centers or prospect’s home.Converts appointments into enrollments.Checks enrollment paperwork for accuracy and completion.Coordinates new member’s first visit with their primary care physician.Maintains enrollment rate that is deemed acceptable.Achieves corporate enrollment goals.Communicates effectively in person and by phone.Requires daily use of considerable discretion and judgment.Resolves member issues concerning plan benefits, medication copays, etc.Assists members as deemed necessary.Communicates effectively with other professional and support staff in order to achieve positive customer outcomes.Promotes and contributes to a positive, problem-solving environment.Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations.Participates in meetings, training and in-service education, as required.Performs other duties as assigned.
Qualifications and Education:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.High school graduate or equivalent; or equivalent combination of education and experience.Agent License 2-15 (Life, Health & Variable Annuity) or 2-40 (Health), in good standing, requiredCertificate of completion for either Gorman or AHIP for corresponding yearCopy of Continuing Education transcripts.National Producer Number.Valid drivers license.Reliable transportation.Must be goal and result driven (ability to meet quotas).Flexible schedule in order to meet with prospective members during non-business hours.Excellent computer knowledge is required, including proficient knowledge of Microsoft Office.Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.Ability to work effectively independently and in a team environment.Ability to write reports, business correspondence, and procedure manuals.Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.Ability to calculate figures and amounts, such as discounts, interest, commissions, proportions, percentages, area and volume.Ability to define problems collects data, establish facts, and draw valid conclusions.Strong decision-making, analytical skills.Must be self-motivated, organized and have excellent prioritization skills.Must be able to work in a fast paced environment.Excellent customer service skills.
What Sets Us Apart:Join Solis Health Plans as an Internal Sales Agent and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!
Position is FULLY ONSITE Monday-Friday.Location: 9250 NW 36th St, Miami, FL 33178.**BILINGUAL IN ENGLISH AND CREOLE IS REQUIRED**Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members!Join our winning Solis Team!
Position Summary:Solis Health Plans is looking for a Member Services Representative primarily responsible for providing quality, professional service to all customers when calls are received through the Member Services Department via telephone, written or in-person in accordance with Plan guidelines.
Essential Duties and Responsibilities:Handles telephone, written and in-person inquiries in a courteous, professional, thorough, and timely manner to assure member satisfaction.Assists callers on inquiries regarding coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, medical group/PCP, explanation of how the plan works and how to utilize services, assists with information regarding referrals or authorizations, member complaints, identification card requests.Must Report to the Doral HQ.Responsible for maintaining customer service levels (abandonment rate, speed of answer and service level) within established parameters.Is knowledgeable on plans benefit, CMS and Plans policies and procedure.Applies high level of subject matter knowledge to solve a variety of common business issues.Provides quality services effectively to increase the overall level of customer service and satisfaction as measured by CMS.Identifies the differences between a Grievance, Appeal or Coverage Decision and process the request through the appropriate channels.Identify, handle, document and/or route Utilization Management inquiries appropriatelyIdentify and document Coverage Determinations.Documents all inquiries and complaints.Interacts with other departments about member issues or concerns.Approaches work in a meticulous and thorough manner, pays attention to detail and follows company scripts.Manages time effectively and prioritizes tasks to meet deadlines.Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.Ensures compliance with all HIPAA, OSHA, and other federal, state and local regulations.Participates in meetings, trainings and in-service education, as required.Highly regulated environment.Time frames to handle issues are in accordance with CMS time frames.Interacts with members, family members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.
Qualification and Education:Minimum of High School diploma or equivalent.Minimum of 1year healthcare experience is required, with a preference for plan experience.Working knowledge of the Privacy and Security Health Insurance Portability and Accountability Act (HIPAA) regulations.Excellent communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.Excellent computer knowledge is required, including proficient knowledge of Microsoft OfficeFamiliarity with healthcare laws, regulations and standards.Ability to compute basic arithmetic and work with numbers.Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.Ability to work effectively independently, work with very little supervision and in a team environment.Ability to read, analyze, and interpret technical procedures or governmental regulations.Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.Ability to define problems, collect data, establish facts, and draw valid conclusions.Strong decision-making, analytical skills.Must be self-motivated, organized and have excellent prioritization skills.Must be able to work well under stressful conditions.Must be able to work in a fast paced environment.Fluency in English and Spanish.
What set us apart:Join Solis Health Plans as a Member Services Representative and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected, and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued. Please check out our company website at www.solishealthplans.com to learn more about us!
Position is FULLY ONSITE Monday-Friday. Location: 9250 NW 36th St, Miami, FL 33178.**Bilingual in ENGLISH AND SPANISH is required**Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members! Join our winning Solis Team! Position Summary:Solis Health Plans is looking for a Member Services Representative primarily responsible for providing quality, professional service to all customers when calls are received through the Member Services Department via telephone, written or in-person in accordance with Plan guidelines.
Essential Duties and Responsibilities:Handles telephone, written and in-person inquiries in a courteous, professional, thorough, and timely manner to assure member satisfaction.Assists callers on inquiries regarding coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, medical group/PCP, explanation of how the plan works and how to utilize services, assists with information regarding referrals or authorizations, member complaints, identification card requests.Must Report to the Doral HQ.Responsible for maintaining customer service levels (abandonment rate, speed of answer and service level) within established parameters.Is knowledgeable on plans benefit, CMS and Plans policies and procedure.Applies high level of subject matter knowledge to solve a variety of common business issues.Provides quality services effectively to increase the overall level of customer service and satisfaction as measured by CMS.Identifies the differences between a Grievance, Appeal or Coverage Decision and process the request through the appropriate channels.Identify, handle, document and/or route Utilization Management inquiries appropriatelyIdentify and document Coverage Determinations.Documents all inquiries and complaints.Interacts with other departments about member issues or concerns.Approaches work in a meticulous and thorough manner, pays attention to detail and follows company scripts.Manages time effectively and prioritizes tasks to meet deadlines.Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.Ensures compliance with all HIPAA, OSHA, and other federal, state and local regulations.Participates in meetings, trainings and in-service education, as required.Highly regulated environment.Time frames to handle issues are in accordance with CMS time frames.Interacts with members, family members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.
Qualification and Education:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum of High School diploma or equivalent.Minimum of 1year healthcare experience is required, with a preference for plan experience.Working knowledge of the Privacy and Security Health Insurance Portability and Accountability Act (HIPAA) regulations.Excellent communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.Excellent computer knowledge is required, including proficient knowledge of Microsoft OfficeFamiliarity with healthcare laws, regulations and standards.Ability to compute basic arithmetic and work with numbers.Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.Ability to work effectively independently, work with very little supervision and in a team environment.Ability to read, analyze, and interpret technical procedures or governmental regulations.Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.Ability to define problems, collect data, establish facts, and draw valid conclusions.Strong decision-making, analytical skills.Must be self-motivated, organized and have excellent prioritization skills.Must be able to work well under stressful conditions.Must be able to work in a fast paced environment.Fluency in English and Spanish.
What set us apart:Join Solis Health Plans as a Member Services Representative and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!
