What are the responsibilities and job description for the Member Services Representative position at Medical Associates?
If you are looking for a customer service based position that has a variety of clerical duties, offers a flexible schedule, and the opportunity to work from home if desired, your search is over!
Medical Associates Health Plans is looking for a full-time Member Services Representative to join our team!
Who You Are:
- Dedicated to providing superior customer service
- Able to adapt to various customers and their needs
- Have excellent verbal communication
- Comfortable learning and navigating various computer programs and phone queues
- Excited to work closely with team members in a fast-paced environment
Work Schedule: Monday through Friday, 8:00am to 5:00pm for training period. Opportunity for work from home after training if desired!
- Single or Family Health Insurance with discounted premium rates for wellness program participation.
- 401k with immediate matching (50% on the dollar up to 7% of pay additional annual Profit Sharing
- Flexible Paid Time Off Program (24 days off/year)
- Medical and Dependent Care Flex Spending Accounts
- Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.
What You'll Be Doing:
- Respond to phone, in-person, written or e-mail inquiries from members, employers, brokers, providers, pharmacies as well as internal customers, in accordance with department standards. Perform research on inquiries and resolve; educate members on benefits, Explanation of Benefit forms, the use of the website and other tools and documents utilized by members.
- Possess knowledge and ability to communicate to internal and external customers regarding benefit plans, including medical, prescription drug and other employee benefit plans offered
- Interpret and enter necessary data and documentation into member and authorization subsystems of core business processing system as necessary to support the member services department; possess knowledge to examine, process, calculate and administer claims according to internal processing guidelines.
- Assist in review and resolution of complaints, appeals and grievances as needed.
- Complete all additional assigned projects and duties.
Knowledge, Skills and Abilities:
Experience: One to three years of similar or related experience.
Education: High school diploma or GED required.
Other Skills: Excellent telephone presence. Familiar with Microsoft Office applications, particularly Word and Excel.
