Member Services Representative
6 days ago
Member Services Representative are the primary point of contact for member inquiries, issues and requests. Service is primarily conducted by telephone, but also includes serving walk-in customers to the Member Services Department. Responsibilities Researches and resolves complex member inquiries and problems including, eligibility verification, benefits, referrals, authorization process and status, complaints, issues with appeals, denials, and claims questions in a timely, respectful, caring and competent manner. Answers telephone calls promptly and minimizes delays that may lead to abandoned calls. Informs and educates members on managed care, health plan benefits, and operational policies and procedures and services. Corrects and updates basic enrollment data daily at the time of the member’s request. (PCP change, address or name change, correction, etc.) Provides Chinese/English language interpretation services when necessary, including assisting with arranging of medical appointments, contacting contracted PBM for prescription issues, and DME exchange/return, etc. Contacts providers, members and in-house departments to obtain information and resolve issues. Performs initial research of problem claims, pulls files, compiles necessary information and forwards to proper department for resolution. Documents all member/provider encounters into the Member Service Inquiry Module. Assists the Marketing Department with walk-in prospects by promoting CCHP and answering questions regarding the health plan. Alerts management of repeat phone calls due to issues that have not been resolved within standards. Recommends suggestions for improving workflow and service. Exercises discretion in working with confidential information. Member Services Specialist is under mandatory requirement to work in assigned CCHP office locations and take turns to work on rotation scheduled shifts. Accepts and performs other duties as assigned. Qualifications Minimum 1+ years of experience in customer services, call center, or similar Prior experience in health plan experience preferred Fluency in English and Cantonese Excellent oral communication, customer service and organizational skills Ability to work under pressure in a busy call center environment Attention to detail and willingness to exercise initiative Excellent decision making, research and problem solving skills Ability to deal effectively with difficult and emotional people and issues. Display a high level of confidence and able to explain information to customers in ways that are clear, concise and objective. Physical Requirements Able to lift up to 30 pounds Use proper body mechanics when handling equipment Standing, walking and moving 50% of the day. Compliance Requirements Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs. Base Pay Scale Starting at $23.80-$28.62/hour. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. #J-18808-Ljbffr
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Customer Service Representative
4 weeks ago
San Antonio, United States Customer Service Representative Full timeSeeking aCustomer Service Representative for a direct hire opportunity in San Antonio, TX for our client a Global Logistics Company that offers sophisticated logistical solutions backed by the world's largest global logistics network. Essential Duties and Responsibilities: Entering Shipment Orders intoproprietary Transportation Management System. Check...
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Member Service Representative
3 months ago
San Francisco, United States Exos Partners Full timeEXOS is a leader in the field of human performance, a category it created more than 20 years ago. For two decades weve stood side by side with the very best, coaching individuals, teams, and communities to higher levels of performance. And weve done it all by pioneering and leveraging sports science and proprietary tools across mindset, nutrition, movement,...
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Field Service Representative
1 week ago
San Francisco, California, United States LIFESAFE SERVICES LLC Full timeJob SummaryWe are seeking a highly skilled Field Service Representative to join our team at LIFESAFE SERVICES LLC. As a key member of our operations team, you will be responsible for performing scheduled maintenance, inspections, and troubleshooting of equipment in the field.Key Responsibilities:Conduct regular equipment inspections to ensure optimal...
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Branch Services Representative
3 days ago
San Francisco, California, United States San Francisco Federal Credit Union Full timeJob SummaryThe Branch Services Representative serves as the primary point of contact between the member and the Credit Union, providing a wide range of services to meet the financial needs of our members. This role requires strong customer service and sales skills, as well as the ability to work effectively in a team environment.Key ResponsibilitiesMember...
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Member Service Representative
6 hours ago
San Antonio, United States University Health System Full timeServes as a liaison to members and providers in resolving member services issues. Provides information to Community First Health Plan members by phone. Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) related po Member Service, Representative, Member Services, Retail, Healthcare, Health
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Member Services Representative
1 week ago
San Francisco, California, United States YMCA of San Francisco Full timeCareers with a Purpose Envision a workplace where your daily contributions have a positive impact on individuals and communities. As a leading nonprofit organization dedicated to enhancing community well-being through youth development, healthy living, and social responsibility, the YMCA of San Francisco provides more than just employment -- we offer a...
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Member Services Representative
1 week ago
San Francisco, California, United States YMCA of San Francisco Full timeJoin a Purpose-Driven Organization Imagine a career where your daily efforts contribute positively to the lives of individuals and communities. The YMCA of San Francisco, a leading nonprofit dedicated to enhancing community well-being through youth development, healthy living, and social responsibility, offers more than just employment; we provide a...
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Member Services Representative
1 week ago
San Francisco, California, United States YMCA of San Francisco Full timeCareers with a Purpose Envision a workplace where your daily contributions have a positive impact on individuals and communities. As a premier nonprofit organization dedicated to enhancing community well-being through youth development, healthy living, and social responsibility, the YMCA of San Francisco provides more than just employment -- we offer a...
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Senior Member Service Representative
4 days ago
San Francisco, California, United States Patelco Credit Union Full timeAbout Patelco Credit UnionPatelco Credit Union is a not-for-profit financial institution dedicated to building financial health and wellbeing for our members. With a rich history dating back to 1936, we have grown from $500 in assets to over $9 billion in assets and are the 7th largest credit union in California with branches throughout Northern...
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Field Service Representative
1 week ago
San Francisco, California, United States LIFESAFE SERVICES LLC Full timeJob SummaryWe are seeking a highly skilled Field Service Representative to join our team at LIFESAFE SERVICES LLC. As a key member of our operations team, you will be responsible for performing scheduled maintenance, inspections, and troubleshooting of equipment in the field.Key Responsibilities:Conduct regular equipment inspections to ensure optimal...
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Member Services Representative
3 months ago
San Diego, United States CABRILLO CREDIT UNION Full timeJob DescriptionJob DescriptionDescription:PRIMARY OBJECTIVEThe Member Services Representative is responsible for providing a variety of transactional teller services and the highest quality of member service to members by phone or in person, as well as information on the full range of credit union products and services. Providing account information,...
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Bilingual Member Services Representative
6 days ago
San Diego, United States Dexian DISYS Full timeBilingual Member Services Representative Job Title: Bilingual Member Services Representative Location: San Diego, CA Duration: 12 months contract with extension Pay Range: $23.39/hr. - $25.39/hr. Hybrid: 100% on site until after training, and then hybrid. Tasks & Responsibilities: Dedicated Contact Center Representative with a proven track record of...
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San Francisco, California, United States Hallmark Aviation Services Full timeJob Title: Baggage Service Representative**About the Role**We are seeking a highly skilled and detail-oriented Baggage Service Representative to join our team at Hallmark Aviation Services. As a key member of our airport operations team, you will be responsible for ensuring the smooth handling of baggage for our airline partners.Key Responsibilities:Utilize...
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Member Services Representative
3 days ago
San Antonio, Texas, United States Taymax Group Full timeJob SummaryWe are seeking a highly motivated and customer-focused Member Services Representative to join our team at Taymax Group. As a key member of our fitness center team, you will be responsible for delivering exceptional customer service to our members, prospective members, and guests.Key ResponsibilitiesCustomer ServiceProvide a positive and welcoming...
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Member Services Representative
3 weeks ago
San Diego, United States Associated Students Full timeJob DescriptionJob DescriptionStarting Rate: $16.85 Per hourGENERAL PURPOSE: Under the supervision of the Member Services Coordinator, the Member Services Representative is responsible for upholding the Aztec Recreation values of Wellness, Integrity, Safety, Service, Professionalism, Excellence, and Respect. Member Services Representatives will be held...
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Customer Service Representative
2 days ago
San Francisco, California, United States KETER ENVIRONMENTAL SERVICES LLC Full timeAbout the RoleWe are seeking a highly skilled and motivated Customer Service Representative to join our team at KETER ENVIRONMENTAL SERVICES LLC. As a key member of our customer-facing team, you will be responsible for providing exceptional service to our commercial customers, ensuring their needs are met and exceeded.Key ResponsibilitiesSchedule Service...
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Customer Service Representative
2 weeks ago
San Francisco, United States Pls Financial Services, Inc. Full timeOverviewPLS: People. Location. Service PLS-which stands for People - Location - Service-is a leading retail provider of alternative financial services. The PLS Group, headquartered in Chicago, is comprised of over 200 financial service centers in 12 states. Through our check cashing stores, we provide consumers with convenient financial products and...
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Member Services Representative
2 days ago
San Antonio, Texas, United States Taymax Group Full timeJob SummaryWe are seeking a highly motivated and customer-focused individual to join our team as a Member Services Representative. As a key member of our team, you will be responsible for providing exceptional customer service to our members, prospective members, and guests.Key ResponsibilitiesCustomer ServiceProvide a superior level of customer service to...
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Member Services Representative
3 days ago
San Antonio, Texas, United States Crunch , Inc. Full timeJob SummaryWe are seeking a highly motivated and customer-focused Member Services Representative to join our team at Crunch Fitness - Undefeated Tribe. As a key member of our front desk team, you will be responsible for providing exceptional service to our members and guests, ensuring a warm and welcoming environment that exceeds their expectations.Key...
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Senior Member Service Representative
2 months ago
San Antonio, United States University Health System Full timeHas comprehensive knowledge of STAR Kids and STAR PLUS programs in order to serve as a liaison to members and providers regarding benefits and services, resolving member and provider issues, providing information regarding all aspects of the Special Member Service, Representative, Senior, Service, Retail, Healthcare, Health