Member Services Representative, Sr. addresses more complex health plan or HMO 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 and written requests. Being a Member Services Representative, Sr. provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative, Sr. requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Member Services Representative, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
POSITION SUMMARY:
The Data Coordinator always presents a positive image to Florida Health Care Plans members. Collects, manages, reports data, and serves as departmental typist, (for correspondence, forms, spreadsheets, etc.) as needed. Will be proficient in all computer functions required for this position and always maintain confidentiality. Proficient at filing and tracking files. Must be flexible in meeting demands of all department operations. This position requires proficiency in answering calls, responding to emails, and in person support for members, co-workers, and management.
QUALIFICATIONS:
Education, skills and experience: