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 Patient Service Representative will provide services, timely and efficiently, at appropriate levels to all patients and in all settings served by the department. The PSR will also perform tasks and duties as outlined in the Department’s Policy and Procedure Manual: will assist in assigned administrative tasks, and will maintain competencies through participation in educational and orientation programs. Good communication skills are required as well as the ability to work as a team to ensure quality patient care.
LICENSURE/CERTIFICATION/REGISTRATION:
License-None
Certification-None
Clear All
0 Member Services Representative, Sr. jobs found in Lawton, OK area