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Member Service Representative

1 month ago


San Jose, United States Visionaire Partners Full time

Member Services Representative Exciting opportunity to join a 1st class organization that has excellent benefits, including a pension plan. RESPONSIBILITIES: Serve as the main point of contact for our members, unions, employers, providers, and vendors on benefit, claims, and eligibility issues, education, and questions. Ability to travel (Yosemite and Monterey, CA) up to 20% to 25%. Receive and record walk-in and telephone inquiries regarding plan benefits, claims, and eligibility. Serve as the face of our company at all on-site enrollment events and benefit presentations, as needed. Perform telephonic enrollment functions and in-person outreach as needed. Encourage members to take steps to get involved in programs to improve their health. Recognize and communicate issues to management, including trends and anomalies. Research benefit, eligibility, and claim issues and initiate corrective action with relevant departments. Maintain up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc., that will affect the performance of daily tasks. Assist in special projects as requested by management. This is a direct-hire position in San Jose, CA. Typically, you will spend 1 to 3 days in the San Jose office, one day in Monterey, and 1 to 2 days in Yosemite every two weeks. Travel will be about 25% with some overnight stays (travel expenses reimbursed). You must be flexible to cover for the other Member Services Representative if they are on PTO or if we have to modify the schedule based on the customers' needs. The company has an incredible culture and benefits, including a 401(k), Awesome Pension Plan, Tuition Assistance, and an Employee Assistance Program (EAP). REQUIRED SKILLS: 1+ years of experience with elite white-glove delivery customer service (highly preferred in a healthcare, insurance, Union, or community engagement environment). Fluent in English and Spanish (bi-lingual). Ability to travel to Yosemite and Monterey up to 25% (we reimburse for mileage or public transportation but not a car service). Experience in a call center. Excellent communication skills. Excellent job stability. PREFERRED SKILLS: Working knowledge and experience in enrollment requirements and processes. Working knowledge in complex claims processes and complex self-pay processes, including payment, vacation hours, and leave of absence applications. Must be authorized to work in the US. Sponsorships are not available. #J-18808-Ljbffr