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 Sonder’s 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 associate’s 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)

Salary : $23 - $25