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)
Description:
Handling inbound calls from providers checking eligibility and/or claim status for members.
Call center environment taking inbound and outbound calls
Respond to both standard and more difficult customer inquiries regarding various products and services via the phone or email in an easy to understand manner
Research customer inquiries and follow up with customers as needed via email or outbound phone calls
Ability to troubleshoot basic website errors/question
Assisting customers with payments and payment related questions, policy changes, explaining coverages and rate changes, etc.
About TEKsystems:We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About the Company:
TEKsystems
About TEKsystems:
Company Size:
5,000 to 9,999 employees
Industry:
Staffing/Employment Agencies
Founded:
0
Website:
https://www.teksystems.com/en/