About Oxbridge Health:

We are an early-stage healthcare company designed to challenge the current paradigm of how people access healthcare, how providers are organized and paid, and how employers engage their employees to finally break the curve that has been crushing corporations and consumers alike for decades. We are a seasoned team with proven track records of success in not only building organizations, but delivering impact through our collective vision and our challenging convention that has served as models for many players in the space today.

We are building a new form of health insurance designed around the power of episodes of care. Many of us have been pioneers in this space, through multiple organizations and approaches, and now believe that the technology, data, provider acceptance and consumer willingness make this the right time to make this happen.

Job Summary:

The Care Coordinator plays a pivotal role in ensuring our members fully understand and effectively utilize their episode of care benefits. This role requires an understanding of healthcare benefit plans, insurance terminology, and excellent communication skills. The ideal candidate will demonstrate empathy, patience, and strong problem-solving abilities to deliver a positive experience for members during their healthcare journey.

Key Responsibilities:

Member Assistance:

• Provide comprehensive support to members, helping them to understand and maximize their episode of care benefits.
• Respond to inquiries via phone, email, or chat, offering clear and accurate information to resolve questions and concerns.
• Initiate outgoing communication to assist members in utilizing their Episode Advantage benefits

Benefit Plan Explanation: Clearly explain details of Episode Advantage benefits, including covered services, benefit allowance, eligibility, co-payments, deductibles, and any limitations or exclusions.

Portal Support: Guide members in using the member portal, focusing on functionalities related to Episode Advantage benefits to optimize their overall benefits usage.

Claims Support: Assist in tracking claims related to episode of care benefits, ensuring correct association with Episode Advisor Care Team milestones and resolving claim disputes or denials.

Network Navigation: Help members locate in-network healthcare providers and facilities, providing directories and guidance for selecting appropriate providers.

Benefit Changes and Updates: Keep members informed about any changes or updates to their episode of care benefits.

Complaint Resolution: Handle and escalate member complaints, ensuring timely and satisfactory resolution.

Feedback Collection: Collect and communicate member feedback for process improvement.

Collaboration: Work cross-functionally with other teams (claims processing, case management, provider relations) to address complex member issues.

Qualifications:

• Knowledge of healthcare benefit plans and insurance terminology.
• Excellent communication and interpersonal skills.
• Empathetic, patient, and strong problem-solving abilities.
• Demonstrated ability to manage tasks in an orderly and efficient manner and maintain organized workflows
• Experience in customer service, particularly in a healthcare setting, is preferred.
• Proficiency in navigating digital tools and member portals.
• Ability to work collaboratively in a team environment.
• Previous experience in a healthcare-related customer service call center is highly desirable.
• Self-starter with the ability to thrive in a dynamic, evolving environment