Member Service Representative – Managed Care
Irving, TX (Dallas-Fort Worth Area)
*** This is a Full-Time, Benefits Available, CONTRACT assignment, expected to last around 3 months, or longer! ***
Member Service Job Summary:
Member Service Background:
- Receives, documents, researches and responds to customer inquiries following established policies, procedures and standards. (Answer, identify, research, document, and respond to a diverse and high volume of inbound and outbound health insurance related.)
- Prepares a variety of correspondence and documents in response to customer inquiries, following departmental procedures and compliance guidelines. (Meet quality, quantity, and timeliness standards.)
- Facilitates timely research and issue resolution through interaction and communication with the appropriate parties, which includes but is not limited to, department team members, employees within the organization, physician offices, and/or contracted plan representatives.
- Works cohesively with team members to ensure delivery of outstanding customer service, in a positive work environment, that supports the department’s ongoing goals and objectives.
- Fulfills informational needs of clients for care coordination of members, appropriate access to contracted providers, services of contracted managed care organizations, employee benefits, health and dental plan inquiries, and services of staff such as utilization review, prior authorization, billing and contract management.
- Requires an education level of at least a high school diploma or GED.
- At least 1 year experience Medicare Enrollment Experience and/or 1 year of Medisys System Experience.
- Knowledge of health care systems, including Medicare and related state programs is a significant plus.
- Computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
- Must test at a around of 35 wpm typing with a high level of accuracy.
- Basic computer literacy (MS Office) and typing skills are necessary.
- Bilingual in English and Spanish is a plus.