Member Services Specialist

Job Summary (List Format) :

• Provide service and support to managed care customers via phone in-person and written communication.
• Act as the primary liaison between members and the health plan.
• Demonstrate strong understanding of healthcare benefits products and insurance issues relevant to customers.
• Facilitate member and provider understanding of plan coverage and benefits by efficiently researching and responding to inquiries.
• Record all customer interactions (verbal and written) in the Management Information System (MIS).
• Maintain accurate documentation of all contacts including phone calls walk-ins and mail inquiries for audit and reporting purposes.
• Handle all incoming and outgoing calls to resolve customer issues and questions.
• Triage and forward phone requests to appropriate departments such as Utilization Management and Provider Relations.
• Respond to written correspondence in a timely and professional manner.
• Assist in training and re-training both new and current employees.
• Utilize excellent communication skills and proficiency with MIS Microsoft Word and Microsoft Excel.
• Requires a High School Diploma and at least 2 years of customer service experience in healthcare insurance or a call center environment.

Key Skills

Criminal Justice,Account Payable,Economics,Front End,Facilities Management,Domestic

Employment Type : Full Time

Experience : years

Vacancy : 1