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Member Services Rep I

Member Services Rep I

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. The incumbent will have daily and extensive contact with members and service providers to resolve complex issues, interpret policies/procedures, explain benefits, respond to requests for service, survey members and solve problems.


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. Knowledge of Excellent customer service and telephone techniques and etiquette.  Health Maintenance Organizations (HMO) desirable.