Description: Under the supervision of the Member Services Supervisor and the direction of the Member Services Manager, the Member Services Representative will perform new member orientations and respond to inquiries from members and providers regarding Plan benefits, Plan policies, claims issues and facilitate appropriate resolutions.
Requirements: High School Diploma from an accredited school or equivalent; plus one (1) year of college. Two (2) years’ experience in a customer service organization or related field may be substituted for one (1) year of college. ** Bilingual Spanish/English (Tier I) Certificate preferred. Typing skills of 45+ NWPM; certificate required within one year of issuance. One (1) or more years of recent experience in customer service related field with a high degree of problem solving and decision making. Strong telephone and communication skills required. Excellent customer service and telephone techniques and etiquette. Health Maintenance Organizations (HMO) desirable. Work under pressure; work independently and manage multi-task responsibilities; be willing and able to assist and educate the member; intervene effectively in a crisis situation on behalf of an upset, distraught, dissatisfied, confused or angry member; solve complex and comprehensive problems; organize and set priorities; adhere to state and federal timelines; have excellent communication skills both written and verbal and work in a rapidly evolving work environment.
We have an excellent benefit package to include: health care, dental, life, 457b and 401a plan, and other supplemental benefits. As a condition of employment, a satisfactory drug test and background check are required. E.O.E.