Senior Resolution Representative

3 weeks ago


San Antonio, United States University Health System Full time

Full Time

12238 Silicon Drive

Clerical

Day Shift

POSITION SUMMARY RESPONSIBILITIES

Responsible for assuring complaints, website inquiries, nurse advice administrative call reports and correspondence are responded to timely. Any databases utilized in this unit should be maintained, updated promptly and precisely as changes occur, to ensure compliance of CFHP policies and procedures. Provides for efficient operation of the member complaint process and the after hours activities process, and serves as the liaison between members and other departments in the health plan, including the Member Services telephone unit, Health Services Management, Network Management and Quality Management. Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) related policies in regards to all aspects of operations within Member Services.

EDUCATION/EXPERIENCE

High school diploma or its equivalent is required. College or completion of commercial school courses in business functions is preferred. Must be computer literate, with a minimum of two years experience in Microsoft Word and Microsoft Excel or similar programs. Two years experience in office administration and Microsoft Access is preferred. Bilingual recommended (English/Spanish).



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