Member Service Representative
Oxford, Mississippi
Position Summary:
Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner
Hours for this Position:
– Mon-Fri 8:00-5:00
– About every 4-6 weeks they’ll work a late shift on Monday (11a-8p)
– About once every other month they’ll work a Saturday 8a-5p & will take a day off during the week to make up for it.
Advantages of this Opportunity:
- Work for a Fortune 500 Healthcare Plan
- Excellent Pay and career growth in the healthcare field
- Excellent hours
Required Skills
What We Look For:
- 1+ year of experience in Medicare, Medicaid managed care or insurance environment.
- 3+ years of customer service experience in a call center environment.
- Claims and billing experience
- Bi-lingual a plus.
Responsibilities
More Insight of Daily Responsibilities:
- Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters
- Provide assistance to members and/or providers regarding website registration and navigation
- Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries
- Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
- Process written customer correspondence and provide the appropriate level of follow-up in a timely manner
- Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment
- Identify trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards
- Work with other departments on cross functional tasks and projects
- Maintain performance and quality standards based on established call center metrics including turn-around times
Want More Information?
Interested in hearing more about this great opportunity? Reach out to Kurt at kurt@healthcaresupport.com for immediate consideration.
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Salary
Based on Experience