Member Services Representative addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls, or written questions. Being a Member Services Representative provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Member Services Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
-Maintain a positive and helpful attitude
-Provide a pleasant customer service experience
-multi-task , be organized, and pay attention to details
-Accurately handle cash and check transactions
-Open new accounts
-Assist existing and prospective members
-Other duties assigned by manager
Job Duties:
Communication method(s) used:
Work Remotely
Job Type: Full-time
Benefits:
Physical setting:
Schedule:
Education:
Experience:
Work Location: In person