Health Navigator I

Job Summary

Providing phone, email, and chat-based customer service, the full-time Health Navigator I will analyze member inquiries regarding benefits and health program options while working remotely.

Key responsibilities

• Handle inquiries related to medical, dental, and pharmacy claims, providing accurate information and solutions to members
• Conduct detailed research and follow-up on member issues, collaborating with internal departments as necessary
• Utilize the Moda 360 Navigator Console to assist members in understanding and accessing recommended health programs

Required qualifications

• High school diploma or equivalent
• Experience in claim processing or customer service, preferably in a medical/dental office or pharmacy setting
• Practical knowledge of medical, dental, and pharmacy terminology
• Ability to complete training as a Customer Service Representative with Moda Health
• Proficiency in Microsoft Office products, including Outlook and Teams