Member Services Representative

7 days ago


Doral, Florida, United States SOLIS Health Plans Full time
About Solis Health Plans

Solis Health Plans is a Medicare Advantage Company that provides innovative solutions to improve the healthcare experience for its members and providers. Our mission is to deliver high-quality, personalized service that exceeds expectations.

Job Summary

We are seeking a highly skilled Member Services Representative to join our team. This individual will be responsible for providing exceptional customer service to our members, addressing their inquiries, and resolving issues in a timely and professional manner.

Key Responsibilities
  • Handle customer inquiries via phone, email, and in-person, providing accurate and timely responses to ensure member satisfaction.
  • Assist members with coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, and other related matters.
  • Maintain accurate records of customer interactions and resolve issues in accordance with company policies and procedures.
  • Collaborate with internal teams to resolve complex issues and provide exceptional customer service.
  • Stay up-to-date on company policies, procedures, and regulatory requirements to ensure compliance.
  • Participate in ongoing training and development to enhance skills and knowledge.
Requirements
  • High school diploma or equivalent required; 1 year of healthcare experience preferred.
  • Working knowledge of HIPAA regulations and ability to maintain confidentiality.
  • Excellent communication, interpersonal, and problem-solving skills.
  • Proficient in Microsoft Office and ability to learn new software systems.
  • Ability to work in a fast-paced environment and prioritize tasks effectively.
  • Fluency in English and Creole required.
What We Offer

Solis Health Plans offers a comprehensive benefits package, including medical, dental, and vision coverage, as well as a 401(k) plan with a 100% company match. We are committed to providing a supportive and inclusive work environment that fosters growth and development.



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