We are a leading healthcare services provider dedicated to delivering exceptional care experiences to our members. Our team is committed to fostering a culture of compassion, collaboration, and excellence in service delivery.
Required Skills And ExperienceProficiency in medical terminology or a background in healthcare, such as nursing assistant/technician or front office experience in a medical setting.
Formal education beyond high school (Associate degree preferred).
Demonstrated customer service experience, preferably in a call center environment, with exceptional phone etiquette.
Strong administrative and PC skills, including a high typing speed.
Familiarity with medical terminology.
Experience with authorization processes is advantageous.
Role OverviewAs a Member Services Representative, you will play a pivotal role in delivering high-quality, member-centric service by leveraging your knowledge of our plans, products, systems, and procedures. Your responsibilities will include:
Providing personalized and attentive service to our members, ensuring their needs are met or exceeded.
Assisting members in locating primary care physicians, specialists, and dentists, guiding them through the process with clarity and empathy.
Thoroughly explaining the benefits of our wellness care management programs to members, promoting proactive healthcare management.
Collaborating with our team to support nurses in researching providers, eldercare options, and nursing homes, facilitating informed decision-making for our members.
Accurately documenting interactions and information in our Care Advance system, ensuring data integrity and confidentiality.
Engaging with members over the phone, both inbound and outbound, to assess their eligibility for our clinical programs or to provide information about our services.
Referring or facilitating warm transfers to wellness and care management resources, as well as other relevant departments and vendors within our organization.
Processing provider requests promptly and efficiently, maintaining effective communication channels.
Join Our TeamIf you are passionate about making a difference in people's lives and thrive in a dynamic, team-oriented environment, we invite you to apply for this rewarding opportunity. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth and development.
Please note: The above description is intended to outline the general nature and level of work being performed by individuals assigned to this position. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required.
Employment Type: Contractor