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)
Asian Health Services, founded in 1974, provides health, social, and advocacy services for all regardless of income, insurance status, immigration status, language, or culture. Our approach to wellbeing focuses on “whole patient health,” which is why we provide more than primary care services, including mental health, case management, nutrition, and dental care to more than 50,000 patients in English and 15 languages: Korean, Lao, Burmese, Mandarin, Cantonese, Spanish, Portuguese, French, Mien, Karen, Mongolian, Karenni, Tagalog, Khmer, and Vietnamese.
We offer medical, dental, and mental health services for all ages.
LOCATION: HMC
JOB SUMMARY:
With supervision from the Senior Member Services Manager, learns to determines initial and continuing eligibility for health and social services by screening and interview patients to assess financial payer sources and status.
Entry Level: This is the entry-level for this job. Initially, under close supervision, incumbents learn to determine and administer cases.
As experience is gained, the caseload is expanded and incumbents are expected to perform more independently.
Intermediate Level: This is the experienced level for this job, fully competent to perform the full range of duties under minimal supervision. Policies, procedures, and guidelines are provided and supervision is available for consultation under unusual circumstances.
\nBENEFITS:
Medical, Dental, Vision premiums 100% paid by AHS
12 Vacation Days
12 Sick Days
12 Holidays and 3 Floating Holidays
3% 403B Employer Contributions and up to 2% Employee Match Contribution
Transportation Benefit Paid by AHS
FSA/Dependent Care Assistance
Long Term Disability