Member Service Representative

2 weeks ago

Worcester, United States KNF&T Staffing Full time

Overall Responsibility: To deliver high quality customer service to doctors or doctor\'s office staff, members, community partners and plan sponsor representatives in a professional, respective and helpful manner. Process claims in a timely, accurate manner. Permanent position - \$50K with Benefits - Hybrid after training. Minimum of 2 days in office. Key responsibilities and accountabilities: \ Respond to inbound telephone calls, faxes and emails from doctors or doctor\'s office staff, and plan sponsor representatives in a timely and professional manner; \ Respond to inbound telephone calls, faxes and emails from members or member representatives in a timely and professional manner; \ Process dental claims on system for all clients; \ Process claim corrections from daily EDI reports; \ Document communications with doctors and doctor\'s office staff, and plan sponsor/employer representatives; \ Document communications with members and member representatives; \ Respond to claim inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner; \ Respond to benefit coverage inquiries from members and member representatives in a timely and professional manner; \ Respond to eligibility inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner; \ Maintain department productivity and quality expectations; \ Maintain knowledge of dental plan designs, exclusions, limitations and exceptions for each client; \ Adhere to all process and procedural guidelines; \ Any other duties as assigned Skills and Attributes: \ Ability to provide outstanding service \ Ability to work independently to achieve goals and objectives within defined timeframes \ Ability to process information through computer systems \ Ability to adjust priorities and manage time wisely in a fast-paced environment; \ Ability to communicate in a clear, concise, understandable manner, and listen attentively to others; \ Ability to prioritize and manage workflow; \ Ability to meet deadlines; \ Team player; ability to get along well with others and function as part of a work group; \ Excellent data entry skills; Experience: \ Customer Service \ Basic knowledge of MS Windows, MS Word, MS Excel; \ Strong organizational skills; \ Multilingual a plus.

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