Demo

Member Service Representative

SNI Companies
Boston, MA Full Time
POSTED ON 1/25/2025
AVAILABLE BEFORE 4/20/2025

This position is a 2-month temporary assignment

The ideal candidate :

We are looking for tenacious, personable, and compassionate individuals who are able to solve problems while delivering outstanding customer service to our members. Individuals who are reliable, empathetic, and thrive in a challenging work environment, you could be a great addition to our team. Ability to service our members in Spanish as well as English is a plus.

  • Be a resource for members by providing accurate and timely responses to their benefit and health plan questions.
  • Respond and effectively triage member phone calls to accurately route to appropriate area.
  • Work with care management team to address the needs of members, caregivers and other constituents.
  • Conduct all follow up activities in a timely and accurate manner ensuring member expectations are met.
  • Meticulously document all member and prospective member interactions in a Centralized Electronic System.
  • Responsible for the scheduling of member appointments, transportation, translation, and interpretation services.
  • Initiates prior authorization intake process.
  • Assist in resolving member billing discrepancies.

Provide members with any requested documents including provider listings in their areas.

  • Complete comprehensive appeal and grievance intakes.
  • Collaborate with the member to accurately document their appeal or grievance concern by ensuring all necessary information to start the process is captured.
  • Assist with timely resolution of concerns or complaints conveyed by members and their representative.
  • Conduct research to provide accurate and informed resolution to members inquiries.
  • Collect supporting data and documentation relevant to members’ care.
  • Connect members to their providers through Telemedicine accessibility.
  • Must act in compliance with HIPAA, state and federal regulations when assisting members
  • Other duties as assigned
  • Working Conditions :

    The MSR position requires the ability to sit at a desk, while talking on the telephone and using the computer, for eight hours each day in a distraction free environment.

  • Required : A broadband or cable internet connection with a minimum speed of 200 Mbps. Satellite Internet, T-Mobile 5G Internet and Mobile 5G hotspot will not be compatible with our systems.
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