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Member Services Representative

2 months ago

Menasha WI, United States TEKsystems Careers Full time

  • Location: *
  • Must be located in WI
  • Remote
  • Description:*
The Member Experience Representative’s primary focus is to answer phone, or email inquiries from providers, members, customers or brokers regarding questions of coverage, claim status, benefit interpretation, billing and/or authorizations.
  • Document details of the interaction within the database, including any additional action steps taken as follow up.
  • Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations.
  • Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.
  • During telephone call, probe and ask appropriate questions to identify specifics of what caller is inquiring about to ensure first call resolution.
  • Follow-up with customers or other departments on any outstanding issues or concerns. Escalate appropriate issues to Supervisor or appropriate individual.
  • Support our members by answering calls and proactively work to resolve our members questions and concerns.
  • Strive for first call resolution, working to resolve member issues at the point of contact.
  • Use dual monitors while leveraging computer-based resources to find answers to customers questions and help simplify next steps for members.
  • You may reach out to internal departments or external resources to help resolve a member concern.
  • Additional Skills & Qualifications:*
  • Experience working in a customer service focused industry strongly desired.
  • Experience working in a call center preferred.
  • Knowledge of basic insurance concepts preferred.
  • Medical Insurance experience
About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.