Member Services Customer Service Representative

3 weeks ago

Torrance, United States BayLeaf HR Solutions Full time

**Member Services Customer Service representative**
**Assignment Start Date: Asap**
**pay : $21/hr - $20/hr**

**Work Schedule: M-F 8:30-5 pm**
**contract: 6 months**
**Company: Torrance Memorial IPA**
**Location: 23326 Hawthorne Blvd. #200 Torrance, Ca 90505**

**Job Details**:
**Summary of essential duties**:
**Handles member and health plan phone calls with professionalism and courtesy at all times**
**Maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner**
**Advises health plans, members, providers, and Management of progress made towards resolution of member complaints, grievances, and appeals and advices of any problems encountered**
**At all times acts in accordance with all applicable federal, state regulations**
**Accurately and completely documents ALL Member communications, appeals and grievances using Patient Center or other documentation system.**
**Answers incoming calls within standard time-frames on the toll-free and TTY phone lines.**
**Answer incoming calls from Health Providers, Health Plans and members requesting status updates and information on Claims, Authorizations Eligibility**
**Demonstrates excellent telephone etiquette at all times.**
**Transfer incoming calls to appropriate departments when applicable**
**Identifies, researches, and resolves any Member issues/inquiries regarding Claims, Eligibility, Authorizations for Service, etc. promptly and responds to member with complete information.**
**Make outbound calls for follow up on various member matters.**
**Verifies member eligibility as needed and/or requested on individual health plan sites**
**Meets department goals and expectations**
**Attend all mandatory company or department t meetings**
**Documents all department productivity**
**Report to each scheduled shift on time, and commence work and perform essential job function at the start of each scheduled shift**
**Acts as a back-up to the Company’s receptionist as needed and as requested. Will cover reception calls for breaks, lunch, and other times as necessary**
**Actively participates in all staff meetings**
**Collects information, makes decisions, takes appropriate action, and follow tasks through to completion.**
**Assists with Member Outreach Program orientation, events, meetings, etc.**
**Updates excel spreadsheets as needed**

**Job Types**: Full-time, Contract, Temporary

Pay: $20.00 - $21.00 per hour

Expected hours: 40 per week

**Benefits**:

- Health insurance

Experience level:

- 1 year
- Under 1 year

Shift:

- Day shift

Weekly day range:

- Monday to Friday

Work setting:

- Office

Ability to Relocate:

- Torrance, CA: Relocate before starting work (required)

Work Location: On the road

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