Member Services Rep
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Job Location:
Fountain Valley, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
4 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Title: Member Services Rep
Location: Fountain Valley CA
Duration: 2 Months
Job Type: Contract
Rate: $24.64
Note: Top 3 Keywords: 1- Managed Healthcare/Health Plan Customer Service 2. Member Grievances & Appeals Processing 3. Specialty Coding Certification
Top Required Skills
- Customer Service & Member Support
- Call Center/Transaction Processing
- Communication & Documentation
Must-Have Skills:
- Minimum 2 years of experience in a transaction-based or call center environment
- Strong verbal and written communication skills
- Ability to build rapport and demonstrate empathy with members
- Basic computer skills (MS Word Excel)
- Typing speed of 45 WPM
- Ability to multitask and meet productivity and quality standards
- Attention to detail and strong organizational skills
- Ability to maintain confidentiality (HIPAA compliance)
Nice-to-Have Skills:
- Experience in a managed healthcare or health plan environment
- Bilingual Spanish/English
- Bachelors degree
- Experience handling grievances appeals or pre-authorizations
Key Responsibilities and Duties:
- Serve as the primary point of contact for members via phone email internet and written correspondence
- Document and track member provider and sponsor interactions accurately
- Educate members on benefits policies rights and responsibilities
- Process member grievances appeals and service requests
- Support multiple service queues (Claims Medical Management Provider Services)
- Review member claims history to ensure accurate benefit tracking
Requirements:
- High School Diploma or GED (required)
- 2 years of call center or transaction-based experience
- Typing speed of at least 45 words per minute
- Basic proficiency with Microsoft Word and Excel
- Specialty coding certification (required)
Key Skills
- Commercial Property Paralegal
- JAVA/J2EE
- Building Construction
- Javase
- Administrative Services
