Member Services Specialist
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Job Location:
Irving, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
2 hours ago
Vacancies:
1 Vacancy
Job Summary
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.
- 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
