Member Services Representative, Sr. jobs in Rhode Island

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)

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Member Services Outreach Representative
  • Abacus Health Solutions
  • Cranston, RI FULL_TIME
  • About Us

    Abacus Health Solutions is an innovative health management company with a strong history in the development and management of chronic condition programs. Utilizing the latest in healthcare technologies, Abacus translates evidence-based medicine into real world interventions. Our programs for diabetes and hypertension are built to foster high rates of adoption, resulting in healthier, more productive employees.

    Abacus values diversity and is committed to creating an inclusive environment for all employees. We believe in creating teams made up of individuals with various backgrounds, experiences, and perspectives. This results in greater innovation and collaboration, leading to better solutions. As such, we seek to recruit, develop, and retain the most talented people from a diverse candidate pool. Abacus offers a competitive benefits package and a hybrid work schedule allowing work from home and in-office work.

    Company Background

    From its inception in 1988 and at its core, Abacus Health Solutions has been a research and development firm. Today Abacus translates evidence-based medicine to real world interventions for our clients and their employees.

    A strong behavioral science background shapes the development of all our solutions. Abacus uses these strengths and an experienced team of healthcare experts, technologists, and clinicians to develop and deploy innovative health behavior change tools and targeted programs to help employers control rising healthcare costs and provide high quality health benefits that optimize the health and productivity of their workforce. Abacus works with every client to develop a program that fits the needs and goals of each unique organization. We are excited and passionate about the work we do and the success of our programs has enabled our recent growth.

    Job Description

    We are an innovative Rhode Island based health management company with customers throughout the U.S. seeking a full-time Member Services Outreach Representative to provide support and encouragement to participants in our health management programs.

    Our company continues to grow, provides a professional and supportive, friendly environment, and the successful and motivated candidate will have opportunities for career growth.

    Primary Job Function

    • Re-engage participants in our diabetes program and other programs through outbound support calls and email.
    • Welcome all participants to our program through outbound calls and email.

    Responsibilities

    • Provide customer support to all program participants via outbound calls and email.
    • Resolution of participant issues and concerns.
    • Proficient computer skills, including utilization of Excel and/or web-based programs for data entry.
    • Provide guidance and support to participants who may have limited experience with using web-based programs.
    • Accurate documentation of calls, forms, faxes, and member communications.
    • Provide Quality Assurance of data entered into member forms/ record

    Required Skills

    • “People skills” Looking for someone who is upbeat, positive, and enjoys helping others.
    • Ability to project empathy and caring in dealing with people who have chronic health conditions.
    • Demonstrate strong verbal communication and listening skills.
    • Be able to use Microsoft Office and call center software.
    • Ability to multi-task without compromising quality of work.
    • Well organized and attentive to detail.
    • Be a supportive team member.
    • Bi-lingual skills (English and Spanish) are a plus, but not required.
    • Ability to promote program/product with results or soft sell.

    Job Requirements

    • BA/BS or other equivalent degree preferred but not required.
    • Minimum of 1 year of call center experience.

    Our benefits package includes:

    • Company-sponsored health, dental, and vision coverage currently through Blue Cross Blue Shield of RI
    • 2 weeks of paid vacation, increased to 3 weeks after your first year at the company
    • 2 weeks of paid sick time
    • 2 paid personal days
    • 11 paid holidays
    • 401k plan with 3% automatic company-paid contributions
    • Flexible Spending Account for pre-tax payment of out-of-pocket health and dependent/childcare costs
    • Employee profit-sharing bonuses

    Job Type: Full-time

    Pay: From $42,000.00 per hour

    Benefits:

    • 401(k)
    • Dental insurance
    • Employee assistance program
    • Flexible schedule
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Professional development assistance
    • Referral program
    • Tuition reimbursement
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift

    Work Location: Hybrid remote in Cranston, RI

  • 14 Days Ago

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Member Services Representative
  • Planet Fitness - The Core Group
  • Pawtucket, RI PART_TIME
  • Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective me...
  • 22 Days Ago

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Member Services Representative
  • Planet Fitness - The Core Group
  • Rumford, RI PART_TIME
  • Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective me...
  • 22 Days Ago

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Member Services Representative
  • Planet Fitness - The Core Group
  • Wakefield, RI PART_TIME
  • Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective me...
  • 22 Days Ago

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Member Services Representative
  • Planet Fitness - The Core Group
  • North, RI PART_TIME
  • Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective me...
  • 2 Months Ago

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Member Services Representative
  • Planet Fitness - The Core Group
  • Providence, RI PART_TIME
  • Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective me...
  • 2 Months Ago

Rhode Island (/ˌroʊd -/ (listen)), officially the State of Rhode Island and Providence Plantations, is a state in the New England region of the United States. It is the smallest state in area, the seventh least populous, the second most densely populated, and it has the longest official name of any state. Rhode Island is bordered by Connecticut to the west, Massachusetts to the north and east, and the Atlantic Ocean to the south via Rhode Island Sound and Block Island Sound. It also shares a small maritime border with New York. Providence is the state capital and most populous city in Rhode Is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Member Services Representative, Sr. jobs
$49,630 to $62,098

Member Services Representative, Sr. in Alamogordo, NM
In the role of Member Service Representative you will wear many hats and your talents will be crucial in the following areas.
January 05, 2020
Member Services Representative, Sr. in Wilmington, DE
Provides excellent service to members, guests, and program participants in the facility and on the phone, contributing to member retention.Builds relationships with members; helps members connect with each other and the Y.Handles and resolves membership concerns Able to effectively and safely evacuate persons from the facility if neededEnsures Y building and property is secure during shift Replaces soap, paper towels, and other supplies in the facility as needed; inventory control as required.
February 12, 2020
Member Services Representative, Sr. in Oakland, CA
Improving Members' experiences is at the heart of every Community position.
December 08, 2019