Customer Service Claims Support
: Job Details :

Join Our Team as a Member Service Representative and Make a Difference in the Lives of Our MembersAre you passionate about delivering exceptional customer service and making a positive impact on people's lives? Do you have a strong background in healthcare and a ability to communicate complex information in a simple and compassionate way? We're looking for a talented and dedicated Member Service Representative to join our team and provide top-notch support to our members and healthcare providers.Responsibilities:As a Member Service Representative, you will be the primary point of contact for our members and healthcare providers, responsible for:* Providing compassionate and dedicated support to ensure an exceptional member experience* Educating members on various elements of benefit plan information and answering questions regarding their benefits* Triaging claims and escalating issues as needed* Assisting members in finding accepting providers and facilities that address their needs* Coordinating with Member Advocates to resolve issues related to provider access escalations* Accurately documenting and resolving all inquiries in a clear and complete manner* Meeting or exceeding individual and departmental quality standards and performance goalsQualifications:To be successful in this role, you'll need:* 2+ years of experience in health plans, benefit plans, claims, and/or healthcare* 2+ years of experience in member service in a healthcare environment* Strong written and verbal communication skills* Excellent problem-solving skills and ability to work in a fast-paced environment* Compassion and empathy when working with members* Strong attention to detail and ability to manage multiple priorities* Proficiency in Microsoft Office, specifically Excel, Outlook, Word, and Zendesk* Bachelor's degree or equivalent job experience