Member Services Customer Service Representative:
- Duration: 6 months contract (possibility of extension)
- Schedule: Monday - Friday 8:30am - 5:00pm
- Pay: $23/hour
Requirements:
- Minimum 2 years of experience as medical member service rep
- COVID vaccinated required
Summary of essential duties:
- Provides excellent customer service while responding to customer requests via phone, fax or email.
- Handles member and health plan phone calls with professionalism and courtesy at all times.
- Maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
- Advises health plans, members, providers, and Management of progress made towards resolution of member complaints, grievances, and appeals and advices of any problems encountered.
- At all times acts in accordance with all applicable federal, state regulations .
- Accurately and completely documents ALL Member communications, appeals and grievances using Patient Center or other documentation system. Answers incoming calls within standard time-frames on the toll-free and TTY phone lines.
- Answer incoming calls from Health Providers, Health Plans and members requesting status updates and information on Claims, Authorizations Eligibility.
- Demonstrates excellent telephone etiquette at all times.
- Transfer incoming calls to appropriate departments when applicable.
- Identifies, researches, and resolves any Member issues/inquiries regarding Claims, Eligibility, Authorizations for Service, etc. promptly and responds to member with complete information.
- Make outbound calls for follow up on various member matters.
- Verifies member eligibility as needed and/or requested on individual health plan sites.
- Collects information, makes decisions, takes appropriate action, and follow tasks through to completion.
- Assists with Member Outreach Program orientation, events, meetings, etc.
Job Types: Full-time, Contract
Pay: $23.00 per hour
Shift:
- 8 hour shift
- Morning shift
Weekly day range:
Application Question(s):
- Are all your immunizations up to date and do you have copies to provide? (REQUIRED)
- This is a 6 months contract- Please confirm and only apply if you are okay with 6 months contract. (There is a possibility of extension). (REQUIRED)
Education:
- High school or equivalent (Required)
Experience:
- Member Service Representative: 2 years (Required)
- Customer service: 1 year (Required)
- Medical receptionist: 1 year (Preferred)
- Phone etiquette: 2 years (Required)
Ability to Commute:
Work Location: In person