Members Services Representative

3 weeks ago

Atlanta, United States Sonder Health Plans, Inc. Full time

Full Job Description
Job Type: Full-time

Pay Range: $23.00 - $25.00 per hour

Job purpose ***This is an in-office position***

The Member Services Representative is responsible for assisting Members, Providers, and Health Plan staff by providing accurate answers to questions regarding the Health Plan in a timely and courteous manner. The Member Care Professional may also facilitate the process for Health-Education related activities and other Health Plan functions and events.

Duties and responsibilities

  • Answers Member/Provider telephone inquiries via ACD phone system.
  • Always maintains professional and courteous telephone etiquette, based on Sonder's core values.
  • Logs all calls in Salesforce (CRM platform).
  • Provides status on claims, prior authorizations, and eligibility to Members and Providers.
  • Facilitate phone conversations with the Member and/or Provider.
  • Assist Members with but not limited to (benefits, PCP lookup, appointment setting, scheduling transportation, and documenting Grievance and/or appeals).
  • Follow up on resolution of inquiries and communicating to all parties involved, in a timely and professional manner.
  • Attends Customer Service & staff training, as required.
  • Assists and supports other Member Services Department staff, as needed.
  • Maintains and keeps in total confidentiality, all files, documents, and records that pertain to the operation of business of the Health Plan.
  • All other job-related duties as it relates to the job function or as delegated by the management team.
Education/ Experience/Qualifications

Required
  • Three-five years minimum Member/Provider service experience in a healthcare environment.
  • Excellent verbal and written communication skills.
  • Excellent organization skills with ability to handle multiple tasks and prioritize work in a fast-paced environment.
  • Three - five-year minimum ACD or comparable multi-line call center experience.
  • Computer literate with high proficiency in Microsoft applications.
Preferred
  • The knowledge, skills and abilities typically acquired through the completion of an associate's degree.
  • Extensive Medicare experience.
  • Familiar with start-up companies.
  • Familiar with CMS regulations.
  • Bilingual (English/Spanish).
Job Type: Full-time

Pay: $23.00 - $25.00 per hour

Benefits:
  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance
Schedule:
  • 8 hour shift
  • Monday to Friday
  • Weekend availability
Work Location: One location

Ability to commute/relocate:
  • Atlanta, GA 30339: Reliably commute or planning to relocate before starting work (Required)
Application Question(s):
  • Do you have Medicare Advantage insurance experience?
Experience:
  • Claims: 1 year (Preferred)
  • Medicare Advantage: 1 year (Preferred)

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