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The role involves responding to calls from health plan members to assist them in determining eligibility for benefits and accessing community social services. The specialist will engage members in assessments, research available resources, and provide options while ensuring member understanding and satisfaction.
Candidates should have at least 1 year of experience in a customer service center and a professional office environment, with a preference for social services or healthcare experience. Strong interpersonal and communication skills, along with a high school diploma or GED, are required, while a Bachelor of Social Work is strongly preferred.
Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com. Role Overview: Join our award-winning health care services firm as a Social Service Specialist/Healthcare Customer Service Representative, working with health plan members and assist them in locating resources relating to benefits and community social services. The Social Service Specialist/Healthcare Customer Service Representative possesses at least 2 years of customer service experience along with strong interpersonal skills and a desire to learn. Prior experience in assisting community members with access to social services is preferred, but extensive training will be provided. We offer a vibrant, positive team culture with a focus on customer service and professional growth. We make a difference in the lives of our customers, our community, and our associates. In fact, our service vision is “Come from a place of kindness in every interaction.” If that aligns with your personal values, and your qualifications meet our requirements, we would like to talk! Role Responsibilities: Responds to calls from client’s members or patients requesting assistance with determining eligibility for benefits or access to community social services. Engages members in standardized assessment to identify needs and eligibility for resources related to social determinates of health. Research, using identified database(s), benefits/community resources available to meet specific person’s needs. Provides options of resources to member and with members input, assesses which resource(s) will be accessible to member. Validates member’s understanding and recording of information provided. Assists the member/patient in accessing identified resources which may include a warm transfer to the identified agency. Where available, provides written information via email or mail to members/patient, identifying applicable social service community resources. Communicates with members/patients via phone, and clarifies the details of Centauri Health Services, properly sets expectations for process and communication to ensure member understanding. Leverages technology and account processing workflows; maintains data integrity with accurate and concise documentation in Centauri Health Services Compass systems and contracted resource systems. Assists members and takes appropriate action to secure resources contracted by Centauri client. Follows established workflow for member follow-up contact to determine outcome and resolution of member identified needs. Provides warm transfer of member/patient to client as indicated by identified need outlined by contracted Centauri client. Documents all member contact in Centauri Health Solutions database. Communicates regularly and works effectively with supervisor and team to ensure that resource information is current and correct. Effectively maintains records of identified incorrect /outdated resource information. Perform miscellaneous clerical tasks (fax, file, data entry, scan, index). Promptly take and return all calls. Answers questions regarding resources. Completes other duties as assigned. Maintains positive professional relationship with client members / patients throughout resolution of identified problems. Ensures member/patient satisfaction through scheduled follow-up contact to validate member/patient receipt of benefits/services. Manage a high volume of outbound/inbound phone calls. Performs miscellaneous administrative tasks as required. Partners with leadership for continuation training Role Requirements: 1+ years of experience working in a professional office & fast-paced environment 1+ year working in Customer Service Center At least one year of social services or health care experience desired Strong interpersonal and communication skills Ability to place and receive calls via computer interface Ability to provide professional customer service Self-motivated and driven to succeed with a proactive work approach and solution focused attitude Strong computer and data entry skills Attention to detail Excellent critical thinking skills Ability to work independently High School Diploma or GED equivalent Bachelor of Social Work strongly preferred, or equivalent degree/work experience We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company’s plan. Centauri currently maintains a policy that requires several in-person and hybrid office workers to be fully vaccinated. New employees in the mentioned categories may require proof of vaccination by their start date. The Company is an equal opportunity employer and will provide reasonable accommodation to those unable to be vaccinated where it is not an undue hardship to the company to do so as provided under federal, state, and local law. Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate. This position is bonus eligible in accordance with the terms of the Company’s plan.
This job posting was last updated on 9/20/2025