• Member Services Representative

    Job Location(s) US-NV-Las Vegas
    Job ID
    2018-1566
    # of Openings
    2
    Category
    Benefits Administration
    Job Type
    Regular Full-Time
  • Overview

    Summary              

    The Member Service Representative will answer incoming participant calls in a professional manner while answering questions timely and correctly

    Responsibilities

    Role and Responsibilities

    • Must possess the ability to explain a PPO benefit plan
    • Must be knowledgeable in all aspects of Trust plans and benefits
    • Answer participant and provider questions concerning various health plan benefits, claim status and eligibility of participants, either by telephone or in person; A minimum of 56 telephone calls per day required
    • Log all calls in the computer as to what questions were asked by each participant or provider and how answered by the service representative in order to provide a complete record of all communication with participants and providers
    • Familiar with the computer system with respect to provider information, participant eligibility and claims status
    • Work with other departments to ensure all follow-up actions have been completed
    • Other duties as assigned

    Qualifications

    Education and/or Experience                                                                                                                                           

    High school diploma or GED and the following:

    • Minimum one year customer service experience; preferably in the medical field
    • Highly detail oriented, excellent problem solving skills, ability to consistently meet minimum production standards, and positive attitude towards staff and participants
    • Extremely dependable and reliable; ability to adapt to change
    • Excellent communication skills both verbal and written
    • Ability to work independently as well as being a team player
    • Demonstrated understanding of confidentiality as it may relate to participants, co-workers and the Trust

    Required Knowledge, Skills and Abilities       

    • Knowledge of multi-line telephone
    • Excellent organizational and multi-tasking skills
    • Intermediate computer skills
    • Advanced written communication skills (typing (55+ wpm), grammar, spelling, correspondence drafting, etc.)
    • Knowledge of office equipment (fax, copier, etc)
    • Thorough understanding of multitasking and attention to detail

    Preferred Skills

    • Ability to work with a variety of people and departments as requested
    • Ability to maintain composure under stressful conditions
    • Ability to communicate in English clearly and concisely, both orally and in writing
    • Ability to perform duties with awareness of all Trust requirements and policies
    • Understanding of confidentiality and commitment to abide by confidentiality regulations
    • Understand the importance of practicing good ergonomics in the workplace

     

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