Member Services Representative

Education Essential Level High School Diploma Yes Roles & Responsibilities This position is to provide service and support to our managed care customers through verbal or written communication. This position acts as the primary liaison both telephonic and in-person between all members and the plan. Responsibilities Facilitates member & provider understand of the plan coverage and benefits by thoroughly researching inquiries in an efficient and professional manner Records all contact with customers, both verbal & written in the current MIS system Required to assist in training/re-training new and current employees Maintains accurate documentation of all telephone contact, walk-in customers, any mail inquiries by documenting to ensure a clear audit trail for reporting purposes Minimum Qualifications Responsible for handling all incoming calls and the making of outgoing calls as needed in order to resolve any issues or questions Triage phone request to other areas such as Utilization Management and Provider Relations Handles incoming written correspondence in a timely and professional manner Must have excellent understanding of benefits, products, & other health care and/or insurance issues as they pertain to our customers (internal/external) Excellent communication and knowledge of MIS system Including but not limited to Microsoft Word and Microsoft Excel