Member Service Representative

Full Job Description Job Type: Full-time Pay Range: $23.00 $25.00 per hour Job purpose This is an in-office position The Member Services Professional is responsible for assisting Members, Providers, and Health Plan staff by providing accurate answers to questions regarding the Health Plan in a timely and courteous manner. The Member Care Professional may also facilitate the process for Health-Education related activities and other Health Plan functions and events. Duties and responsibilities Answers Member/Provider telephone inquiries via ACD phone system. Always maintains professional and courteous telephone etiquette, based on Sonders core values. Logs all calls in Salesforce (CRM platform). Provides status on claims, prior authorizations, and eligibility to Members and Providers. Facilitate phone conversations with the Member and/or Provider. Assist Members with but not limited to (benefits, PCP lookup, appointment setting, scheduling transportation, and documenting Grievance and/or appeals). Follow up on resolution of inquiries and communicating to all parties involved, in a timely and professional manner. Attends Customer Service & staff training, as required. Assists and supports other Member Services Department staff, as needed. Maintains and keeps in total confidentiality, all files, documents, and records that pertain to the operation of business of the Health Plan. All other job-related duties as it relates to the job function or as delegated by the management team. Education/ Experience/Qualifications Required Three-five years minimum Member/Provider service experience in a healthcare environment. Excellent verbal and written communication skills. Excellent organization skills with ability to handle multiple tasks and prioritize work in a fast-paced environment. Three five-year minimum ACD or comparable multi-line call center experience. Computer literate with high proficiency in Microsoft applications. Preferred The knowledge, skills and abilities typically acquired through the completion of an associates degree. Extensive Medicare experience. Familiar with start-up companies. Familiar with CMS regulations. Bilingual (English/Spanish). Job Type: Full-time Pay: $23.00 $25.00 per hour Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance Schedule: 8 hour shift Monday to Friday Weekend availability Work Location: One location Ability to commute/relocate: Atlanta, GA 30339: Reliably commute or planning to relocate before starting work (Required) Application Question(s): Do you have Medicare Advantage insurance experience? Experience: Claims: 1 year (Preferred) Medicare Advantage: 1 year (Preferred)