Member Services Representative (Medicare)
Posting ID: JP-001979184
This position is responsible to apply knowledge of business, products, members and operations to accurately and effectively fulfill member service requests and inquiries. Ensure adherence to policies and procedures and meet service level expectations by following established guidelines and standards. Achieve fluency in at least one core product or service line
·Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner. Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues. Educate members and external customers on policies and procedures related to members’ health care program.
·Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of policies, procedures, and regulations. Utilize appropriate resources to respond to member inquiries.
·Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures. Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.
·Identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor. Assist in the development and communication of resolutions to internal staff, as requested.
·Demonstrate and maintain a thorough and complete working knowledge of appropriate information management systems, and telephone system.
·Maintain good working relationships and open communication with internal and external customers.
·Attend department and other meetings as requested.
·Other projects and duties as assigned.
Customer service, Call center, Health care, Data entry, Insurance, Member service, Health plan, medicare
One year call center experience or two years customer service experience. Preference given to candidates with health insurance (HMO), physician group practice, or community agency. Proficient PC skills required knowledge of Microsoft office.
Working knowledge of medical claims and/or medical billing processes. Proficient computer skills; knowledge of Microsoft office, Amisys, and MACESS type software packages.
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Recruiter: Jenne Childs